Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 33358 | CA |
NPI | 1235402892 |
---|---|
Provider Name | Dr. Howard Radding |
First Address | Ojai, CA 93024-0177 |
Second Address | Ojai, CA 93023 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2012 |
Last Update Date | 13/02/2012 |