Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | ND-361 | CA |
NPI | 1154552776 |
---|---|
Provider Name | Stephen Knight |
First Address | Harbor City, CA 90710-2085 |
Second Address | Harbor City, CA 90710-2085 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2009 |
Last Update Date | 22/09/2014 |