Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | A116367 | CA |
NPI | 1053629527 |
---|---|
Provider Name | Dr. Jeffrey Watson |
First Address | Carlsbad, CA 92008 |
Second Address | San Diego, CA 92161-0002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2010 |
Last Update Date | 12/07/2017 |