Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | 748 | NV |
NPI | 1295716918 |
---|---|
Provider Name | Dr. Todd Jay May |
First Address | Camp Pendleton, CA 92055-5191 |
Second Address | Camp Pendleton, CA 92055-5191 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2005 |
Last Update Date | 29/10/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G26164 | (02) | NV |