Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC24390 | CA |
NPI | 1003061979 |
---|---|
Provider Name | William Geoffrey Gulick |
First Address | Pacific Palisades, CA 90272-0128 |
Second Address | Wilmington, CA 90744-5806 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/11/2008 |
Last Update Date | 19/11/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DC24390 | BOARD OF CHIROPRACTIC EXAMINERS (01) | CA |