Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0216X | Pediatric Rheumatologist | G18029 | CA |
NPI | 1518413558 |
---|---|
Provider Name | George Lockie |
First Address | Escondido, CA 92026-1354 |
Second Address | Escondido, CA 92026-1354 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2016 |
Last Update Date | 30/08/2016 |