Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | G34810 | CA |
NPI | 1013289305 |
---|---|
Provider Name | Dr. Martin Peter Learn |
First Address | Julian, CA 92036-0027 |
Second Address | San Diego, CA 92108-2431 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2012 |
Last Update Date | 01/02/2012 |