Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | A69557 | CA |
Y | 111NI0900X | Internist | A69557 | CA |
N | 207RH0002X | Hospice and Palliative Medicine | A69557 | CA |
NPI | 1184690901 |
---|---|
Provider Name | Dr. Cary C Stewart |
First Address | San Clemente, CA 92673-6957 |
Second Address | San Clemente, CA 92673-6957 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2006 |
Last Update Date | 09/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A695570 | (05) | CA |
H41870 | (02) |