Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | E2895 | CA |
NPI | 1215087770 |
---|---|
Provider Name | Dr. Steven G Farmer |
First Address | San Marcos, CA 92069-8124 |
Second Address | San Marcos, CA 92078-4649 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2007 |
Last Update Date | 18/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T11513 | (02) | CA |