Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | G46103 | CA |
N | 207RC0000X | Internist - Cardiovascular Disease | G46103 | CA |
NPI | 1285612457 |
---|---|
Provider Name | Dr. James T. Heywood |
First Address | San Diego, CA 92127-5705 |
Second Address | La Jolla, CA 92037-1205 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2006 |
Last Update Date | 17/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G461030 | (05) | CA |
A50286 | (02) | CA |