Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC28916 | CA |
N | 111NR0200X | Radiology | DC28916 | CA |
N | 213ER0200X | Radiology | DC28916 | CA |
NPI | 1003852633 |
---|---|
Provider Name | Dr. Setrak Terzian |
First Address | Santa Rosa, CA 95401-5000 |
Second Address | Santa Rosa, CA 95401-5000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2006 |
Last Update Date | 09/03/2017 |