Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | S02814 | CA |
NPI | 1467805358 |
---|---|
Provider Name | James Patrick Kemp |
First Address | Julian, CA 92036-9641 |
Second Address | Julian, CA 92036-9641 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2016 |
Last Update Date | 15/07/2016 |