Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | ND1038 | CA |
NPI | 1003385444 |
---|---|
Provider Name | Ryan Namdarkhan |
First Address | Corona, CA 92883-7334 |
Second Address | Cardiff By The Sea, CA 92007-1743 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2018 |
Last Update Date | 15/11/2018 |