Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 31922 | CA |
NPI | 1073688107 |
---|---|
Provider Name | Dr. Frederick White Hammond |
First Address | San Diego, CA 92108-3872 |
Second Address | San Diego, CA 92108-3872 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2006 |
Last Update Date | 08/07/2007 |