Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | A18714 | CA |
NPI | 1174554117 |
---|---|
Provider Name | Dr. Floyd Monte Purcelli |
First Address | Santa Monica, CA 90404-2102 |
Second Address | Santa Monica, CA 90404-2102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 10/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A187141 | (05) | CA |
A21436 | (02) | CA |