Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | G31524 | CA |
Y | 207XS0106X | Orthopaedic Hand Surgeon | G31524 | CA |
NPI | 1114902202 |
---|---|
Provider Name | Dr. Richard David Tortosa |
First Address | Sacramento, CA 95827-2539 |
Second Address | Yuba City, CA 95991-5077 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2005 |
Last Update Date | 29/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A53497 | (02) | |
GR0002390 | (05) | CA |