Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | G63783 | CA |
N | 207Q00000X | Family Doctor | MD16862 | OR |
N | 207VX0000X | Obstetrician | G63783 | CA |
NPI | 1083892020 |
---|---|
Provider Name | John P Delgado |
First Address | Ashland, OR 97520 |
Second Address | Ashland, OR 97520 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2008 |
Last Update Date | 04/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010194 | (05) | OR |
E79141 | (02) | OR |