Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2081P2900X | Pain Medicine | A83645 | CA |
NPI | 1336108372 |
---|---|
Provider Name | Dr. Feng Bai |
First Address | Tracy, CA 95376-3420 |
Second Address | Tracy, CA 95376-3420 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H46384 | (02) | CA |