Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | A72421 | CA |
NPI | 1306844279 |
---|---|
Provider Name | Daniel Robert More |
First Address | Salinas, CA 93901-2903 |
Second Address | Salinas, CA 93901-2903 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2005 |
Last Update Date | 30/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
GR0071130 | (05) | CA |
I49247 | (02) | CA |
ZZZ19547Z | MEDICARE GROUP NUMBER (01) | CA |