Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 25863 | CA |
NPI | 1164561239 |
---|---|
Provider Name | Yaniv Farbenbloom |
First Address | Encino, CA 91436-2406 |
Second Address | Encino, CA 91436-2406 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2007 |
Last Update Date | 25/04/2019 |