Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | A41625 | CA |
NPI | 1023026838 |
---|---|
Provider Name | Dr. James Norman Logan |
First Address | Long Beach, CA 90814-1857 |
Second Address | Long Beach, CA 90806-2710 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A85672 | (02) | CA |