Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | DC25167 | CA |
NPI | 1063418259 |
---|---|
Provider Name | Dr. Robert Steven Patterson |
First Address | Encino, CA 91316-1319 |
Second Address | Tarzana, CA 91356-2648 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2005 |
Last Update Date | 22/01/2020 |