Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | A95293 | CA |
NPI | 1265588982 |
---|---|
Provider Name | Jeffrey Aaron Sweat |
First Address | Sacramento, CA 95816 |
Second Address | Sacramento, CA 95816 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2007 |
Last Update Date | 12/09/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
RES000 | (02) | CA |