Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0700X | Prosthodontist | 5-0052292 | NY |
Y | 1223P0700X | Prosthodontist | 58078 | CA |
NPI | 1164611455 |
---|---|
Provider Name | Dr. Nathan James Hornsby |
First Address | San Diego, CA 92101-4609 |
Second Address | San Diego, CA 92101-4609 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2007 |
Last Update Date | 03/02/2020 |