Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 32073 | CA |
Y | 111NR0400X | Rehabilitation Chiropractor | 32073 | CA |
N | 111NS0005X | Chiropractic Sports Physician | 32073 | CA |
NPI | 1043587157 |
---|---|
Provider Name | Dr. Trisha Lenore Smith |
First Address | West Hollywood, CA 90069-2557 |
Second Address | Los Angeles, CA 90025-6929 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2011 |
Last Update Date | 18/11/2011 |