Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 200400247 | NC |
Y | 207P00000X | Emergency Physician | A104007 | CA |
N | 207PE0004X | Emergency Medical Services | ME0091008 | FL |
NPI | 1104814680 |
---|---|
Provider Name | Jeffrey Scott Overcash |
First Address | Chula Vista, CA 91911-6658 |
Second Address | Chula Vista, CA 91911-6658 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2005 |
Last Update Date | 21/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
270702100 | (05) | FL |
50036Y | (02) | FL |
I17956 | (02) |