Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 33060 | CA |
N | 111NX0100X | Occupational Health | 33060 | CA |
NPI | 1083082804 |
---|---|
Provider Name | Dr. Paul Michael Cook |
First Address | San Francisco, CA 94158-2392 |
Second Address | San Francisco, CA 94158-2392 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/09/2015 |
Last Update Date | 16/05/2016 |