Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 9889680-1205 | UT |
NPI | 1245322908 |
---|---|
Provider Name | John Thomas Paas |
First Address | Sacramento, CA 95825-5480 |
Second Address | Sacramento, CA 95825-5480 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2006 |
Last Update Date | 10/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2016992 | (05) | NV |
CC8221 | ANTHEM B/C B/S (01) | NV |