Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | C31727 | CA |
NPI | 1053343921 |
---|---|
Provider Name | Dr. David Lipman |
First Address | Ventura, CA 93003-2619 |
Second Address | Ventura, CA 93003-8400 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 04/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A34684 | (02) | CA |