Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | G42810 | CA |
NPI | 1003836370 |
---|---|
Provider Name | Dr. Paul F Nielson |
First Address | Cambria, CA 93428-3607 |
Second Address | Cambria, CA 93428-3607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 25/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A49126 | (02) | CA |