Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NX0800X | Chiropractor Orthopedic Specialist | 18345 | CA |
NPI | 1447243803 |
---|---|
Provider Name | Karl J. Brunn |
First Address | Madera, CA 93637-5606 |
Second Address | Madera, CA 93637-5606 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2005 |
Last Update Date | 09/01/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DC0183450 | (05) | CA |