Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | G37585 | CA |
N | 207L00000X | Anesthesiologist | L4126 | TX |
NPI | 1013069038 |
---|---|
Provider Name | Catherine Ferguson Sims |
First Address | Hemet, CA 92546-0788 |
Second Address | Hemet, CA 92543-3083 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2007 |
Last Update Date | 17/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
050089485 | RAILROAD- MEDICARE (01) | TX |
1465798 | LA- MEDICAID (01) | LA |
153681501 | (05) | TX |
8B7329 | TX-BLUE SHIELD (01) | |
D15042 | (02) | |
G37585 | CA LICENSE (01) | CA |