Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | G78679 | CA |
NPI | 1215918354 |
---|---|
Provider Name | Jean Ding |
First Address | Arcadia, CA 91006-3830 |
Second Address | Arcadia, CA 91006-3830 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2005 |
Last Update Date | 23/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
X87837 | (02) | CA |