Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | A75701 | CA |
NPI | 1063510840 |
---|---|
Provider Name | Mr. David Josephson |
First Address | Los Angeles, CA 90048-6102 |
Second Address | Los Angeles, CA 90048-6102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 10/06/2011 |