Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | G30512 | CA |
NPI | 1013252170 |
---|---|
Provider Name | Dr. James Pointer |
First Address | Petaluma, CA 94954-2365 |
Second Address | Petaluma, CA 94954-2365 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2012 |
Last Update Date | 30/11/2012 |