Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | CPO725 | CA |
N | 222Z00000X | Podiatrist | CPO725 | CA |
N | 224P00000X | Prosthetist | CPO725 | CA |
NPI | 1326263856 |
---|---|
Provider Name | Mr. David Allen Wegner |
First Address | Bakersfield, CA 93301-1816 |
Second Address | Bakersfield, CA 93301-1816 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
XC0007250 | (05) | CA |