Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | C-34000 | CA |
NPI | 1346230307 |
---|---|
Provider Name | Dr. Maurice P. Sherman |
First Address | Del Mar, CA 92014-3859 |
Second Address | Del Mar, CA 92014-3859 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E01711 | (02) | CA |