Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | A135500 | CA |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | DR.0060785 | CO |
NPI | 1023428414 |
---|---|
Provider Name | Dr. Tracey Crothers Didinger |
First Address | Aurora, CO 80042-0429 |
Second Address | Los Angeles, CA 90033 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2014 |
Last Update Date | 16/08/2018 |