Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A38164 | CA |
N | 111NI0900X | Internist | A38164 | CA |
N | 207RC0200X | Critical Care Medicine | A38164 | CA |
Y | 207RP1001X | Pulmonary Disease | A38164 | CA |
NPI | 1073505707 |
---|---|
Provider Name | Dr. John R. Lemoine |
First Address | San Diego, CA 92123 |
Second Address | San Diego, CA 92123 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2005 |
Last Update Date | 20/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A381640 | (05) | CA |
A28551 | (02) | CA |