Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | G85488 | CA |
NPI | 1245263789 |
---|---|
Provider Name | Dr. Lamont Joel Cardon |
First Address | Berkeley, CA 94705-2058 |
Second Address | Berkeley, CA 94705-2058 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2006 |
Last Update Date | 13/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H09145 | (02) | CA |