Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 23032 | CA |
Y | 213EG0000X | General Practice | 23032 | CA |
NPI | 1003813858 |
---|---|
Provider Name | Dr. Richard Jan Schoen |
First Address | Happy Camp, CA 96039-1016 |
Second Address | Yreka, CA 96097-3425 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2005 |
Last Update Date | 23/02/2010 |