Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | A145544 | CA |
N | 207QS0010X | Family Doctor - Sports Medicine | A145544 | CA |
NPI | 1316326952 |
---|---|
Provider Name | Andrew Nobe |
First Address | Orange, CA 92868-3213 |
Second Address | Santa Ana, CA 92701-3576 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2015 |
Last Update Date | 19/10/2021 |