Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175F00000X | Naturopath | ||
Y | 175L00000X | Homeopath |
NPI | 1730598244 |
---|---|
Provider Name | Ed Meyer |
First Address | Pomona, CA 91769-0279 |
Second Address | Pomona, CA 91766-1703 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2014 |
Last Update Date | 06/04/2017 |