Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC26857 | CA |
N | 111NN0400X | Neurology | DC26857 | CA |
NPI | 1134221948 |
---|---|
Provider Name | Dr. Sherry Lanay Chocholaty |
First Address | Irvine, CA 92618-2720 |
Second Address | San Jose, CA 95124 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2006 |
Last Update Date | 11/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DC0268520 | PTAN (01) | CA |
DC26852 | CHIROPRACTIC LICENSE (01) | CA |