Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | G45545 | CA |
NPI | 1740298991 |
---|---|
Provider Name | Bruce F. Paterson |
First Address | Concord, CA 94520-1812 |
Second Address | Concord, CA 94520-1812 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G455450 | (05) | CA |
A50085 | (02) | CA |