Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 21341 | CA |
N | 111NN1001X | Nutrition | 21341 | CA |
NPI | 1558428144 |
---|---|
Provider Name | Teresa Guta |
First Address | Escondido, CA 92025-4402 |
Second Address | Escondido, CA 92025-4402 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2007 |
Last Update Date | 12/06/2009 |