Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | G42229 | CA |
Y | 207ND0101X | MOHS-Micrographic Surgeon | G42229 | CA |
NPI | 1285772152 |
---|---|
Provider Name | Dr. Frank Richard Noodleman |
First Address | Mountain View, CA 94040-4211 |
Second Address | Salinas, CA 93901-4325 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2007 |
Last Update Date | 03/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A48868 | (02) | CA |