Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 127591 | NC |
N | 208600000X | Surgeon | 127591 | NC |
N | 208200000X | Surgeon | 56369 | WI |
N | 208600000X | Surgeon | 56369 | WI |
Y | 2086S0122X | Plastic and Reconstructive Surgery | A115197 | CA |
NPI | 1003090267 |
---|---|
Provider Name | Christian Nathan Kirman |
First Address | Concord, CA 94520-1819 |
Second Address | Concord, CA 94520-1819 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/12/2007 |
Last Update Date | 14/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003090267 | (05) | WI |
52199B | (02) | NC |