Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | G56283 | CA |
N | 207XS0117X | Orthopaedic Spine Surgeon | G56283 | CA |
NPI | 1285703413 |
---|---|
Provider Name | Dr. John Glenn Finkenberg |
First Address | San Diego, CA 92120-5198 |
Second Address | San Diego, CA 92120-5198 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2006 |
Last Update Date | 06/12/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G562830 | (05) | CA |
200013790 | MEDICARE RR PROVIDER# (01) | CA |
F05409 | (02) | CA |