Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | A130408 | CA |
NPI | 1295977957 |
---|---|
Provider Name | Mary Isabel Ragsdale |
First Address | Ventura, CA 93003-3099 |
Second Address | Ventura, CA 93003-3099 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2009 |
Last Update Date | 21/10/2016 |