Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | G537630 | CA |
NPI | 1023052677 |
---|---|
Provider Name | Brian Thomas Courtney |
First Address | Chico, CA 95926-3397 |
Second Address | Chico, CA 95926-3310 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 27/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A93255 | (02) | CA |