Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | A110072 | CA |
NPI | 1073846028 |
---|---|
Provider Name | Dr. James Andrew Washington III |
First Address | Yucaipa, CA 92399-2018 |
Second Address | Yucaipa, CA 92399-2018 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2009 |
Last Update Date | 22/10/2021 |