Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | G47681 | CA |
Y | 111NI0900X | Internist | G47681 | CA |
N | 207RA0201X | Internist - Allergy & Immunology | G47681 | CA |
N | 207RC0000X | Internist - Cardiovascular Disease | G47681 | CA |
N | 207RC0200X | Critical Care Medicine | G47681 | CA |
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | G47681 | CA |
N | 207RG0100X | Gastroenterologist | G47681 | CA |
N | 207RG0300X | Geriatric Medicine | G47681 | CA |
N | 207RH0003X | Hematology & Oncology | G47681 | CA |
N | 207RI0200X | Infectious Disease | G47681 | CA |
N | 207RN0300X | Nephrologist | G47681 | CA |
N | 207RP1001X | Pulmonary Disease | G47681 | CA |
N | 207RR0500X | Rheumatology | G47681 | CA |
NPI | 1205858917 |
---|---|
Provider Name | David Charles Dougherty |
First Address | Bakersfield, CA 93301-2284 |
Second Address | Bakersfield, CA 93301-2284 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 31/07/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A50774 | (02) | CA |
G476810 | MEDICAL (01) | CA |