Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | G46156 | CA |
Y | 2080P0208X | Pediatric Infectious Diseases | G46156 | CA |
NPI | 1477624229 |
---|---|
Provider Name | Mark Harrison Sawyer |
First Address | San Diego, CA 92123-4800 |
Second Address | San Diego, CA 92123-4223 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 03/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G461560 | (05) | CA |