Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | G65826 | CA |
NPI | 1679799266 |
---|---|
Provider Name | Dr. Carl Taswell |
First Address | Ladera Ranch, CA 92694-0890 |
Second Address | Ladera Ranch, CA 92694-0890 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2007 |
Last Update Date | 11/05/2018 |