Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 89271 | CA |
N | 2080P0203X | Pediatric Critical Care Doctor | 32163 | IA |
N | 2080P0203X | Pediatric Critical Care Doctor | 37874 | AZ |
N | 2080P0214X | Pediatric Pulmonologist | 036-128419 | IL |
NPI | 1043206162 |
---|---|
Provider Name | Jeffrey G Lobas |
First Address | Irvine, CA 92603-0673 |
Second Address | Irvine, CA 92603-0673 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2005 |
Last Update Date | 29/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2939868 | (05) | IA |
41639 | WELLMARK (01) | IA |
B54637 | (02) |