| NPI | 1417184102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES LATADY Owner/Provider 650-906-2256 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC28108) |
| 111N00000X Chiropractor (Licence: CA DC26475) | |
| 111NS0005X Chiropractor, Sports Physician (Licence: CA DC24240) | |
| 111NS0005X Chiropractor, Sports Physician (Licence: CA DC18956) | |
| 111NX0100X Chiropractor, Occupational Health (Licence: CA DC18667) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: CA A23308) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA A35335) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A45948) | |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: CA A67511) | |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: CA A49312) | |
| 207X00000X Orthopaedic Surgery (Licence: CA A72343) | |
| 2081N0008X Physical Medicine & Rehabilitation, Neuromuscular Medicine | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA G21506) | |
| 209800000X Legal Medicine (Licence: CA G59606) | |
| Enumeration Date | 2009-06-19 |
| Last Update Date | 2009-09-02 |