Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | G60000 | CA |
Y | 208600000X | Surgeon | G60000 | CA |
N | 208200000X | Surgeon | G60000 | CA |
N | 208600000X | Surgeon | G60000 | CA |
NPI | 1013118801 |
---|---|
Provider Name | Dr. Joseph Kurt Bivens |
First Address | Stockton, CA 95267-0096 |
Second Address | Brawley, CA 92227 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2007 |
Last Update Date | 20/09/2019 |