Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 40320 | CA |
NPI | 1083771604 |
---|---|
Provider Name | Linda Uyeda |
First Address | Tustin, CA 92780 |
Second Address | Tustin, CA 92780 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2007 |
Last Update Date | 08/07/2007 |