Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | A0678960 | CA |
Y | 207QG0300X | Family Doctor - Geriatric Medicine | A67896 | CA |
NPI | 1356395826 |
---|---|
Provider Name | Dr. Christian F Negard |
First Address | Mountain View, CA 94040-6203 |
Second Address | Santa Cruz, CA 95062-1323 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2006 |
Last Update Date | 21/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H24225 | (02) | CA |