Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | MD60118970 | WA |
N | 207PE0004X | Emergency Medical Services | 067375 | MI |
Y | 207Q00000X | Family Doctor | MD60118970 | WA |
N | 208D00000X | General Practice Physician | MD60118970 | WA |
NPI | 1063453595 |
---|---|
Provider Name | Dinesh Vasudev Pai |
First Address | Auburn, WA 98002-5406 |
Second Address | Auburn, WA 98002-5406 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 25/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G37016 | (02) | MI |