Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | 43941 | CA |
N | 213EG0000X | General Practice | 43941 | CA |
N | 1223X0400X | Orthodontists | 43491 | CA |
NPI | 1003991266 |
---|---|
Provider Name | Dr. Federico G Drachenberg |
First Address | Chula Vista, CA 91913-1453 |
Second Address | Chula Vista, CA 91914 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2006 |
Last Update Date | 08/07/2007 |