Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A111036 | CA |
N | 111NI0900X | Internist | A111036 | CA |
Y | 207RA0401X | Internist - Addiction Medicine | A111036 | CA |
NPI | 1669799557 |
---|---|
Provider Name | Dr. Eduardo Pasman Javier JR. |
First Address | Rancho Mirage, CA 92270-3221 |
Second Address | Rancho Mirage, CA 92270-3221 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2010 |
Last Update Date | 02/07/2020 |