Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 31796 | CA |
NPI | 1033297510 |
---|---|
Provider Name | Julia H. Townsend |
First Address | Los Gatos, CA 95032-2425 |
Second Address | Los Gatos, CA 95032-2425 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 11/12/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
V08837 | (02) |