Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | G50664 | CA |
Y | 208600000X | Surgeon | G50664 | CA |
N | 2086S0102X | Surgical Critical Care | G50664 | CA |
N | 2086S0127X | Trauma Surgeon | G50664 | CA |
N | 2086S0129X | Vascular Surgeon | G50664 | CA |
NPI | 1285640243 |
---|---|
Provider Name | Denis Robert Westphal |
First Address | Chico, CA 95973-4916 |
Second Address | Chico, CA 95973-4916 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 27/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G506640 | (05) | CA |
A51767 | (02) |