Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 20A9902 | CA |
N | 111NI0900X | Internist | 20A9902 | CA |
Y | 207RI0200X | Infectious Disease | 20A9902 | CA |
NPI | 1073704326 |
---|---|
Provider Name | Gregory Yervant Warner |
First Address | Vacaville, CA 95687-4172 |
Second Address | Vacaville, CA 95687-4172 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2007 |
Last Update Date | 17/09/2013 |