Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC27865 | CA |
NPI | 1003920067 |
---|---|
Provider Name | Pav Chinchilla |
First Address | Highland Park, CA 90042-3642 |
Second Address | Highland Park, CA 90042-3642 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2006 |
Last Update Date | 08/07/2007 |