Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 49221 | CA |
N | 1223D0001X | Dental Public Health | 49221 | CA |
NPI | 1508990771 |
---|---|
Provider Name | Dr. Euwei Michael Tai |
First Address | Gilroy, CA 95020-4519 |
Second Address | Gilroy, CA 95020-4519 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
49221 | LISENSE NUMBER (01) | CA |