Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | G63130 | CA |
NPI | 1013957679 |
---|---|
Provider Name | Dr. Ross Nathan |
First Address | Long Beach, CA 90807-2666 |
Second Address | Long Beach, CA 90807-2666 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 12/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G631300 | (05) | CA |
E36252 | (02) | CA |
G63130 | MEDICAL BOARD OF CA (01) | CA |