Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 30782 | CA |
NPI | 1205046299 |
---|---|
Provider Name | Dr. Jeffrey Yngve Nordlander |
First Address | Sacramento, CA 95819-4620 |
Second Address | Sacramento, CA 95819-4620 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 08/07/2007 |