Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | G87835 | CA |
N | 207VE0102X | Reproductive Endocrinologist | MD00042176 | WA |
NPI | 1245210582 |
---|---|
Provider Name | Dr. Jon A Proctor |
First Address | Pleasanton, CA 94588-5316 |
Second Address | Fremont, CA 94538-5818 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2006 |
Last Update Date | 20/12/2021 |