Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 10783 | CA |
NPI | 1154414712 |
---|---|
Provider Name | Dr. Raymond Allan Govett |
First Address | Ceres, CA 95307-3222 |
Second Address | Ceres, CA 95307-3222 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10783 | BD CHIROPRACTIC EXAMINERS (01) | CA |
901754 | QME NUMBER WORK COMP (01) | CA |
DC0107830 | MEDI-CAL INDIVIDUAL ID (01) | CA |
T04058 | (02) | CA |