Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | G42802 | CA |
N | 208600000X | Surgeon | G42802 | CA |
Y | 2086S0129X | Vascular Surgeon | G42802 | CA |
N | 208D00000X | General Practice Physician | G42802 | CA |
N | 208G00000X | Cardiothoracic Vascular Surgeon | G42802 | CA |
NPI | 1013014752 |
---|---|
Provider Name | Harry Lifschutz |
First Address | Santa Fe Springs, CA 90670-5820 |
Second Address | Indio, CA 92201-5578 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2006 |
Last Update Date | 24/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G428020 | (05) | CA |
A49122 | (02) | CA |