Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0208X | Pediatric Infectious Diseases | 08415 | RI |
Y | 2080P0208X | Pediatric Infectious Diseases | G88383 | CA |
NPI | 1245285147 |
---|---|
Provider Name | Dr. David L Pugatch |
First Address | Madera, CA 93636-8761 |
Second Address | Madera, CA 93636-8761 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2006 |
Last Update Date | 01/12/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DP32317 | (05) | RI |
G56193 | (02) | RI |