Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | APRN00014 | RI |
N | 363L00000X | Nurse Practitioner | RN2265262 | MA |
Y | 363LA2100X | Nurse Practitioner - Acute Care | 95004482 | CA |
NPI | 1033507876 |
---|---|
Provider Name | Dr. Onofre Gasmen Ayroso |
First Address | Folsom, CA 95630-6446 |
Second Address | Folsom, CA 95630-6446 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/01/2015 |
Last Update Date | 24/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110104477A | (05) | MA |