Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | A95785 | CA |
NPI | 1023265261 |
---|---|
Provider Name | Dr. James Matthew Ridgway |
First Address | Orange, CA 92868-3201 |
Second Address | Bellevue, WA 98004-3822 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2008 |
Last Update Date | 05/12/2019 |