Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | E4302 | CA |
Y | 222Z00000X | Podiatrist | E4302 | CA |
NPI | 1073527081 |
---|---|
Provider Name | Dr. James Todd Beaty |
First Address | Ojai, CA 93023-3100 |
Second Address | Ojai, CA 93023-3100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 24/11/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000E43020 | (05) | CA |
U82801 | (02) | CA |