Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | G66807 | CA |
NPI | 1083639470 |
---|---|
Provider Name | George Delgado |
First Address | San Diego, CA 92108-3117 |
Second Address | San Diego, CA 92108-3117 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2006 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G668070 | (05) | CA |
E92397 | (02) | CA |