Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | G-52082 | CA |
NPI | 1124087838 |
---|---|
Provider Name | Dr. John Richard Dein |
First Address | Sacramento, CA 95819-3633 |
Second Address | Sacramento, CA 95819-3628 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2006 |
Last Update Date | 18/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E14878 | (02) | CA |