Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | G55078 | CA |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | G55078 | CA |
NPI | 1295750255 |
---|---|
Provider Name | David Alan Friscia |
First Address | Rancho Mirage, CA 92270-1058 |
Second Address | Rancho Mirage, CA 92270-3221 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 18/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E47912 | (02) | CA |