Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 20232 | CO |
Y | 2080P0201X | Pediatric Allergist | G39458 | CA |
NPI | 1932212255 |
---|---|
Provider Name | Dr. Edward R.b. Mccabe |
First Address | Aurora, CO 80042-0429 |
Second Address | Los Angeles, CA 90095-3075 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2006 |
Last Update Date | 19/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G394580 | (05) | CA |
42459362 | (05) | CO |
C19020 | (02) | CA |
GR0053510 | (05) | CA |