Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | A45320 | CA |
NPI | 1821164849 |
---|---|
Provider Name | Barbara Macfarlane |
First Address | Monterey, CA 93940-7831 |
Second Address | Monterey, CA 93940-7831 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2006 |
Last Update Date | 27/12/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E64740 | (02) | CA |