Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | G63785 | CA |
Y | 207XS0117X | Orthopaedic Spine Surgeon | G63785 | CA |
NPI | 1295794964 |
---|---|
Provider Name | Janet Dunlap |
First Address | Oceanside, CA 92056-4405 |
Second Address | Oceanside, CA 92056-4405 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2006 |
Last Update Date | 02/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
92056B019 | CHAMPUS (01) | CA |
CP8020 | MEDICARE RAILROAD GROUP # (01) | CA |
F05341 | (02) | CA |
ZZZ72841Z | (05) | CA |