Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | A38770 | CA |
NPI | 1003873522 |
---|---|
Provider Name | Ernesto P Gidaya |
First Address | Anaheim, CA 92801-2802 |
Second Address | Anaheim, CA 92801-2804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2006 |
Last Update Date | 07/08/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A85173 | (02) | CA |