Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | G77134 | CA |
NPI | 1013965748 |
---|---|
Provider Name | Dr. Douglas Andrew Woelkers |
First Address | San Diego, CA 92193-2410 |
Second Address | San Diego, CA 92103-8433 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2006 |
Last Update Date | 07/11/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G771340 | (05) | CA |
G27278 | (02) | CA |