Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 15043 | CA |
N | 111NI0900X | Internist | 15043 | CA |
Y | 207RC0200X | Critical Care Medicine | 15043 | CA |
N | 207RP1001X | Pulmonary Disease | 15043 | CA |
NPI | 1013385061 |
---|---|
Provider Name | Dr. Curtis Daniel Converse |
First Address | Colton, CA 92324-1819 |
Second Address | Colton, CA 92324-1819 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2015 |
Last Update Date | 20/04/2018 |