Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 000G84240 | CA |
NPI | 1013986868 |
---|---|
Provider Name | Dr. John Carter Alden |
First Address | Oakland, CA 94609 |
Second Address | Oakland, CA 94609 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A58447 | (02) |