Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC17731 | CA |
NPI | 1003082900 |
---|---|
Provider Name | Ms. Kim D Kromas |
First Address | San Pedro, CA 90731-2700 |
Second Address | San Pedro, CA 90731-2700 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2008 |
Last Update Date | 30/07/2010 |