Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | 429409 | CA |
Y | 363LP2300X | Nurse Practitioner - Primary Care | 429409 | CA |
NPI | 1013966225 |
---|---|
Provider Name | James M Gocke |
First Address | Lancaster, CA 93534-2371 |
Second Address | Lancaster, CA 93534-2371 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2006 |
Last Update Date | 19/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
S59433 | (02) |