Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | E2659 | CA |
Y | 222Z00000X | Podiatrist | E2659 | CA |
NPI | 1053341909 |
---|---|
Provider Name | Dr. Paul Joseph Morello |
First Address | El Cajon, CA 92021-2231 |
Second Address | El Cajon, CA 92021-2231 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2006 |
Last Update Date | 27/09/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T11426 | (02) | CA |