Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 20A6563 | CA |
NPI | 1053366047 |
---|---|
Provider Name | Dr. Neil Katchman |
First Address | Los Angeles, CA 90084-0001 |
Second Address | Monterey Park, CA 91754-4716 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00AX65630 | (05) | CA |
D97940 | (02) | CA |