Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | G59948 | CA |
NPI | 1003994864 |
---|---|
Provider Name | Douglas Philip Tapper |
First Address | Stockton, CA 95267-0096 |
Second Address | Saint Helena, CA 94574-9554 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 11/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G599480 | (05) | CA |
F41229 | (02) |