Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | G22794 | CA |
NPI | 1003809294 |
---|---|
Provider Name | Eric A Ford |
First Address | Chico, CA 95926-1990 |
Second Address | Chico, CA 95926-1991 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G227941 | (05) | CA |
A41723 | (02) |