Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | A120873 | CA |
NPI | 1134394117 |
---|---|
Provider Name | Frederick N Eko |
First Address | Palm Desert, CA 92260-3821 |
Second Address | Palm Desert, CA 92260-3821 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2008 |
Last Update Date | 01/12/2021 |