Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | A20485 | CA |
NPI | 1013940410 |
---|---|
Provider Name | Dr. Marvin Martin Kripps |
First Address | Escondido, CA 92025-4116 |
Second Address | Escondido, CA 92025-4212 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A22183 | (02) | CA |