Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | G85966 | CA |
NPI | 1013932508 |
---|---|
Provider Name | Dr. John James Regan |
First Address | Santa Monica, CA 90403-4803 |
Second Address | Beverly Hills, CA 90212-1842 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2006 |
Last Update Date | 18/10/2021 |