Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 21266 | CA |
NPI | 1003852823 |
---|---|
Provider Name | Dr. Robert D Kiger |
First Address | Loma Linda, CA 92357-1000 |
Second Address | Loma Linda, CA 92357-1000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2006 |
Last Update Date | 13/07/2007 |