Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | G54674 | CA |
NPI | 1700988268 |
---|---|
Provider Name | Dr. William Stephen Holtz |
First Address | Scottsdale, AZ 85258-4805 |
Second Address | Newport Beach, CA 92660-7725 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E89849 | (02) | CA |