Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 20A5942 | CA |
N | 207Q00000X | Family Doctor | 20A5942 | CA |
NPI | 1134122690 |
---|---|
Provider Name | James F. Yusuf Q. Erskine |
First Address | Sebastopol, CA 95472-4261 |
Second Address | Sebastopol, CA 95472-4261 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2005 |
Last Update Date | 26/12/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00AX59420 | (05) | CA |
F20770 | (02) |