Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | G18002 | CA |
NPI | 1073545497 |
---|---|
Provider Name | Dr. Dale Jackson Cox |
First Address | Porterville, CA 93257-3506 |
Second Address | Porterville, CA 93257-3506 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G180020 | (05) | CA |
A40246 | (02) | CA |