Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | 30316 | AZ |
NPI | 1598104101 |
---|---|
Provider Name | Merlin Stanley Puterbaugh |
First Address | Los Altos, CA 94022-3986 |
Second Address | Los Altos, CA 94022-3986 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2013 |
Last Update Date | 17/06/2013 |