Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC25336 | CA |
NPI | 1003280769 |
---|---|
Provider Name | Thomas Hill |
First Address | Seal Beach, CA 90740-2754 |
Second Address | Seal Beach, CA 90740-2754 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2015 |
Last Update Date | 18/11/2015 |