Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CA32125 | CA |
N | 111NS0005X | Chiropractic Sports Physician | 32125 | CA |
NPI | 1316217524 |
---|---|
Provider Name | Dr. Sandy Marie Baird |
First Address | Oakland, CA 94610-2013 |
Second Address | Oakland, CA 94610-2013 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2012 |
Last Update Date | 26/08/2014 |