Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 20A17446 | CA |
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 286932 | NY |
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | R2982 | TX |
Y | 207RA0401X | Internist - Addiction Medicine | 20A17446 | CA |
N | 207RA0401X | Internist - Addiction Medicine | 286932 | NY |
N | 207RA0401X | Internist - Addiction Medicine | R2982 | TX |
NPI | 1508270539 |
---|---|
Provider Name | Dr. David Son |
First Address | Thousand Oaks, CA 91360-5897 |
Second Address | Thousand Oaks, CA 91360-5897 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2014 |
Last Update Date | 26/08/2019 |