Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | C-28545 | CA |
NPI | 1699766501 |
---|---|
Provider Name | Dr. Harold C Ochsner JR. |
First Address | Long Beach, CA 90807-4221 |
Second Address | Long Beach, CA 90807-4221 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2005 |
Last Update Date | 23/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A33673 | (02) | CA |
AO0304585 | DEA (01) | CA |
C-28545 | STATE LICENCE (01) | CA |