Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | A106043 | CA |
N | 208000000X | Pediatrician | A106043 | CA |
NPI | 1275775173 |
---|---|
Provider Name | Amol P Kamboj |
First Address | Bakersfield, CA 93312-2011 |
Second Address | Bakersfield, CA 93312-2011 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2009 |
Last Update Date | 20/03/2015 |