Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | E4181 | CA |
NPI | 1245205632 |
---|---|
Provider Name | Dr. Jonathan J Uy |
First Address | Hercules, CA 94547-1838 |
Second Address | Hercules, CA 94547-1838 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2006 |
Last Update Date | 31/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000E41810 | (05) | CA |
U73802 | (02) | CA |