Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 33887 | CA |
Y | 111NN0400X | Neurology | 33887 | CA |
NPI | 1689101115 |
---|---|
Provider Name | Stephanie Barbakoff |
First Address | San Diego, CA 92108-1745 |
Second Address | San Diego, CA 92108-1745 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2017 |
Last Update Date | 02/07/2019 |