Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | G84072 | CA |
N | 207PE0004X | Emergency Medical Services | G84072 | CA |
NPI | 1194773101 |
---|---|
Provider Name | Christopher E. Dong |
First Address | Bakersfield, CA 93312 |
Second Address | Bakersfield, CA 93305-4144 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 18/05/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G840720 | (05) | CA |
F61733 | (02) | CA |