Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | G70944 | CA |
NPI | 1003855289 |
---|---|
Provider Name | Bert Gerard Tardieu |
First Address | Salinas, CA 93901-4314 |
Second Address | Salinas, CA 93901-4314 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 24/12/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F78786 | (02) |