Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | G59182 | CA |
NPI | 1073584397 |
---|---|
Provider Name | Michael Ray Holtel |
First Address | San Diego, CA 92131-3940 |
Second Address | San Diego, CA 92131-3940 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2006 |
Last Update Date | 19/06/2013 |