Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | G40119 | CA |
NPI | 1093757957 |
---|---|
Provider Name | James M Loddengaard |
First Address | Torrance, CA 90503-4009 |
Second Address | Torrance, CA 90503-4009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 04/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A48093 | (02) | CA |