Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0200X | Radiology | DC27272 | CA |
Y | 213ER0200X | Radiology | DC27272 | CA |
NPI | 1740354497 |
---|---|
Provider Name | Frank John Navratil JR. |
First Address | Redondo Beach, CA 90277 |
Second Address | Redondo Beach, CA 90277 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2006 |
Last Update Date | 17/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U90998 | (02) | CA |