Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | DC12383 | CA |
NPI | 1629133962 |
---|---|
Provider Name | David Edwin Cox |
First Address | Red Bluff, CA 96080-2444 |
Second Address | Red Bluff, CA 96080-2444 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2006 |
Last Update Date | 08/07/2007 |