Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MD427826 | PA |
N | 208600000X | Surgeon | MD427826 | PA |
N | 2086S0102X | Surgical Critical Care | MD427826 | PA |
Y | 2086S0127X | Trauma Surgeon | MD427826 | PA |
NPI | 1306875810 |
---|---|
Provider Name | Jose Luis Pascual-Lopez |
First Address | Philadelphia, PA 19107-6130 |
Second Address | Philadelphia, PA 19107-6130 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2006 |
Last Update Date | 06/11/2019 |