Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | A22527 | CA |
NPI | 1063499572 |
---|---|
Provider Name | Dr. Leland Gilbert Whitson |
First Address | Redondo Beach, CA 90277-5714 |
Second Address | Redondo Beach, CA 90277-5714 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A23123 | (02) | CA |