Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 21213 | CA |
NPI | 1114948023 |
---|---|
Provider Name | Dr. Pono Victor Aiona |
First Address | Milpitas, CA 95035-5720 |
Second Address | Fremont, CA 94538-2119 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2006 |
Last Update Date | 05/11/2021 |