Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | CPO03604 | CA |
Y | 222Z00000X | Podiatrist | CPO03604 | CA |
N | 224P00000X | Prosthetist | CPO03604 | CA |
NPI | 1003362435 |
---|---|
Provider Name | Jeffrey Elms |
First Address | Bakersfield, CA 93311-9504 |
Second Address | Bakersfield, CA 93311-9504 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2016 |
Last Update Date | 26/08/2016 |