Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | E1383 | CA |
N | 222Z00000X | Podiatrist | E1383 | CA |
N | 111NR0200X | Radiology | E1383 | CA |
N | 213ER0200X | Radiology | E1383 | CA |
N | 213ES0131X | Foot Surgery | E1383 | CA |
NPI | 1164577151 |
---|---|
Provider Name | Dr. Kay S Hara |
First Address | Santa Paula, CA 93060-2511 |
Second Address | Santa Paula, CA 93060-2511 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000E13830 | (05) | CA |
000E13830 | BLUE SHIELD (01) | CA |
T10926 | (02) | CA |