Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | E3706 | CA |
Y | 222Z00000X | Podiatrist | E3706 | CA |
N | 111NR0200X | Radiology | RHD 133809 | CA |
N | 213ER0200X | Radiology | RHD 133809 | CA |
NPI | 1225123789 |
---|---|
Provider Name | Lois R Fleming |
First Address | Redding, CA 96003-2406 |
Second Address | Redding, CA 96003-2406 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 14/10/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000E37060 | (05) | CA |
U27346 | (02) | CA |