Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 5101016933 | MI |
NPI | 1275773640 |
---|---|
Provider Name | Dr. Steven James Wright |
First Address | Rancho Cordova, CA 95670-7956 |
Second Address | Woodland, CA 95695 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/02/2009 |
Last Update Date | 28/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
FN951Z | PTA (01) | CA |
ZZZ13240Z | PTAN (01) | CA |