Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 2005019591 | MO |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | A87272 | CA |
NPI | 1215974563 |
---|---|
Provider Name | Dr. Jon E Oda |
First Address | Madera, CA 93636-8761 |
Second Address | Madera, CA 93636-8761 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2006 |
Last Update Date | 13/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1215974563 | (05) | CA |
200319 | BLUE CROSS BLUE SHIELD (01) | MO |
207491002 | (05) | MO |
2530801 | UNITED HEALTHCARE (01) | MO |
254906V3223 | GROUP HEALTH PLAN (01) | MO |
724554 | HEALTHLINK (01) | MO |
7925639 | AETNA (01) | MO |
9807545 | CIGNA (01) | MO |
I14878 | (02) |