Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | A56140 | CA |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | A56140 | CA |
NPI | 1093871725 |
---|---|
Provider Name | Dr. Raymund J Llaurado |
First Address | Arroyo Grande, CA 93420-1821 |
Second Address | Santa Maria, CA 93454-8902 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2006 |
Last Update Date | 26/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A561400 | (05) | CA |
G99788 | (02) | CA |