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General NPI Number Information
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NPI Number | 1033376975
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Entity Type | Organization
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Legal Business Name | DOROTHY PONTON
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Dates
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Enumeration Date | 05/19/2008
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Last Update Date | 05/19/2008
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Provider Practice Location Address
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Address Line | 3151 OLIN AVE SUITE 101
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City | SAN JOSE
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State | CA
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Zip | 95117-1635
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Country | US
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Telephone | 408-377-9555
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Fax |
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Provider Business Mailing Address
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Address Line | 3151 OLIN AVE SUITE 101
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City | SAN JOSE
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State | CA
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Zip | 95117-1635
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Country | US
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Telephone | 408-377-9555
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DOROTHY PONTON
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Credential | D.C.
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Telephone | 408-377-9555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC26475
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License Number State | CA
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