Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | A76223 | CA |
NPI | 1053565465 |
---|---|
Provider Name | Dr. Jeffrey Dierker Pollard |
First Address | San Jose, CA 95128-4622 |
Second Address | San Jose, CA 95128-4622 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/11/2008 |
Last Update Date | 12/11/2008 |