Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 27583 | CA |
Y | 111NS0005X | Chiropractic Sports Physician | DC27583 | CA |
NPI | 1306918875 |
---|---|
Provider Name | James R Baranski |
First Address | Ventura, CA 93003-5671 |
Second Address | Ventura, CA 93003-5671 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 24/08/2015 |