Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | G85499 | CA |
NPI | 1164510939 |
---|---|
Provider Name | Dr. Patrick Michael Knost |
First Address | Placerville, CA 95667-6512 |
Second Address | Placerville, CA 95667-6512 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G51785 | (02) | CA |