Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 20A6933 | CA |
NPI | 1174596894 |
---|---|
Provider Name | Dr. Leland P Werner |
First Address | Apo, AE 09267 |
Second Address | Arroyo Grande, CA 93420-5911 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2006 |
Last Update Date | 20/04/2008 |