Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 48221 | CA |
NPI | 1114091014 |
---|---|
Provider Name | Dr. J E Arce |
First Address | Redondo Beach, CA 90277-3325 |
Second Address | Redondo Beach, CA 90277 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2006 |
Last Update Date | 31/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1982831673 | (05) | CA |