Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | C54783 | CA |
NPI | 1144238734 |
---|---|
Provider Name | Dr. Brett Ronald Ohlfs |
First Address | Redding, CA 96001-0852 |
Second Address | Redding, CA 96001-0852 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2006 |
Last Update Date | 06/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
36102091 | (05) | IL |
H29888 | (02) | IL |
L83306 | (02) | CA |