Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2081S0010X | Sports Medicine | E5152 | CA |
N | 213ES0000X | Sports Medicine | E5152 | CA |
Y | 213ES0103X | Foot & Ankle Surgery | E5152 | CA |
NPI | 1093078057 |
---|---|
Provider Name | Dr. Tanler Juris Volkmann |
First Address | Santa Monica, CA 90403-5742 |
Second Address | Los Angeles, CA 90073-1003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2012 |
Last Update Date | 25/08/2015 |