Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 25018 | CA |
NPI | 1114367455 |
---|---|
Provider Name | Dr. Andrew Pounds |
First Address | Bakersfield, CA 93306-3760 |
Second Address | Bakersfield, CA 93301-1903 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2013 |
Last Update Date | 01/07/2013 |