Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | G36333 | CA |
NPI | 1013989540 |
---|---|
Provider Name | Dr. Thomas T. Paukert |
First Address | Napa, CA 94558-6417 |
Second Address | Napa, CA 94558-6417 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2006 |
Last Update Date | 21/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G363330 | (05) | CA |
1013989540 | NPI (01) | CA |
A46651 | (02) | CA |