Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 22563 | CA |
NPI | 1790994341 |
---|---|
Provider Name | Gregg Welsh |
First Address | Santa Barbara, CA 93105 |
Second Address | Santa Barbara, CA 93105 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2007 |
Last Update Date | 29/07/2013 |