Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | G29747 | CA |
NPI | 1023177680 |
---|---|
Provider Name | Gary G. Huffaker |
First Address | Pasadena, CA 91188-0001 |
Second Address | Riverside, CA 92505-3043 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G297470 | (05) | CA |
A44143 | (02) |