Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | DC31388 | CA |
NPI | 1548535958 |
---|---|
Provider Name | Mr. Elias Murillo |
First Address | Camarillo, CA 93012-5092 |
Second Address | Oxnard, CA 93030 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2012 |
Last Update Date | 13/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DC31388 | CALIFORNIA STATE LICENCE (01) | CA |