Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | A88432 | CA |
NPI | 1093717472 |
---|---|
Provider Name | Dr. Aaron D. Kromhout |
First Address | San Luis Obispo, CA 93401-4140 |
Second Address | San Luis Obispo, CA 93401-4140 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2005 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A88432 | MEDICAL LICENSE # (01) | CA |
H52447 | (02) | CA |