Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0002X | Hospice and Palliative Medicine | A85801 | CA |
NPI | 1073563714 |
---|---|
Provider Name | Dr. Jeremy Mason Hirst |
First Address | San Diego, CA 92193-2410 |
Second Address | San Diego, CA 92103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2006 |
Last Update Date | 01/06/2018 |