Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | DC 25747 | CA |
NPI | 1144249574 |
---|---|
Provider Name | Dr. Tamara Frances Lund |
First Address | Sonora, CA 95370-4802 |
Second Address | Sonora, CA 95370-4802 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DC25747 | (02) | CA |