Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | MD00048099 | WA |
NPI | 1538354766 |
---|---|
Provider Name | Bryan J Tompkins |
First Address | Los Angeles, CA 90084-5046 |
Second Address | Spokane, WA 99204-2901 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2007 |
Last Update Date | 18/06/2010 |