Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | DC27386 | CA |
N | 111NN1001X | Nutrition | DC27386 | CA |
NPI | 1598810160 |
---|---|
Provider Name | Mr. Jason J Baietto |
First Address | Placentia, CA 92870-5710 |
Second Address | Placentia, CA 92870-5710 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2007 |
Last Update Date | 08/07/2007 |