Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | 181863 | NY |
N | 207SG0201X | Clinical Genetics (M.D.) | F9219 | TX |
Y | 207SG0201X | Clinical Genetics (M.D.) | G76627 | CA |
NPI | 1629040605 |
---|---|
Provider Name | Dr. Allan T Bombard |
First Address | San Diego, CA 92106 |
Second Address | San Diego, CA 92123 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F20058 | (02) |