Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | A54276 | CA |
NPI | 1295730331 |
---|---|
Provider Name | Gregory Horner |
First Address | Pleasanton, CA 94588-8517 |
Second Address | Pleasanton, CA 94588-8517 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2005 |
Last Update Date | 06/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200039899 | MEDICARE RAILROAD (01) | CA |
H05725 | (02) | CA |