Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | G62158 | CA |
Y | 208600000X | Surgeon | G62158 | CA |
N | 2086S0120X | Pediatric Surgery | G62158 | CA |
N | 2086X0206X | Surgical Oncologist | G62158 | CA |
NPI | 1033177167 |
---|---|
Provider Name | Dr. Diana L. Farmer |
First Address | Sacramento, CA 95817-1418 |
Second Address | Sacramento, CA 95817-1418 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2006 |
Last Update Date | 30/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0G6215800 | (05) | CA |
G13617 | (02) | CA |