Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | G50776 | CA |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | G50776 | CA |
NPI | 1427085927 |
---|---|
Provider Name | Dr. Jeffrey L Dobyns |
First Address | Orange, CA 92868-3854 |
Second Address | Orange, CA 92868-3854 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 07/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G507760 | (05) | CA |
00G507761 | MEDI-CAL LEGACY NUMBER (01) | CA |
A51802 | (02) | CA |
G50776 | GROUP PTAN W14179 (01) | CA |