Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | DC17829 | CA |
NPI | 1396868451 |
---|---|
Provider Name | Michael Anthony Spagnoli |
First Address | Calabasas, CA 91372-8549 |
Second Address | Calabasas, CA 91302-3348 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2007 |
Last Update Date | 02/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DC17829 | (02) | CA |