Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 16047 | CA |
NPI | 1790878270 |
---|---|
Provider Name | George Sargeits |
First Address | Lemoore, CA 93246-0001 |
Second Address | Lemoore, CA 93246-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 17/11/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DC160470 | LIC. NUMBER (01) | CA |