Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 20A10349 | CA |
NPI | 1336264290 |
---|---|
Provider Name | Dr. David Paul Foos |
First Address | Sacramento, CA 95815-4807 |
Second Address | Sacramento, CA 95815-4807 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2007 |
Last Update Date | 14/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
20A10349 | CALIFORNIA OSTEOPATHIC MEDICAL LICENSE (01) | CA |
BF9370329 | DEA CERTIFICATE (01) | NV |
SL0386 | MEDICAL LICENSE (01) | NV |