Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist | CA |
NPI | 1366092892 |
---|---|
Provider Name | Dirk Frankenberger |
First Address | Castro Valley, CA 94546-4055 |
Second Address | Castro Valley, CA 94546-4055 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2019 |
Last Update Date | 17/09/2019 |