Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | DC011793 | CA |
NPI | 1609978923 |
---|---|
Provider Name | Dr. Henry Press |
First Address | Thousand Oaks, CA 91359-1918 |
Second Address | Westlake Village, CA 91361-4315 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DC011793 | D.C. LICENSE NUMBER (01) | CA |