Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | G37446 | CA |
Y | 207XS0117X | Orthopaedic Spine Surgeon | G37446 | CA |
NPI | 1336190826 |
---|---|
Provider Name | Dr. Roger P. Thorne |
First Address | San Diego, CA 92127-5705 |
Second Address | La Jolla, CA 92037-1035 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 14/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G374460 | (05) | CA |
A47092 | (02) | CA |