Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | G76399 | CA |
NPI | 1013019017 |
---|---|
Provider Name | Dr. Peter D. Aldrich |
First Address | Los Angeles, CA 90074-0001 |
Second Address | San Diego, CA 92128-3409 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2006 |
Last Update Date | 24/06/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G763990 | (05) | CA |
110108506 | RAILROAD MEDICARE (01) | |
B232 | CHAMPUS (01) | |
F32807 | (02) | CA |