Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1100X | Ophthalmic | G370690 | CA |
NPI | 1831294651 |
---|---|
Provider Name | Dr. David Ernest Thorburn |
First Address | Turlock, CA 95382-2011 |
Second Address | Turlock, CA 95382-2011 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A46937 | (02) | CA |