Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | G61328 | CA |
NPI | 1003867987 |
---|---|
Provider Name | Mr. James J Plunkett |
First Address | San Francisco, CA 94145-0123 |
Second Address | Fresno, CA 93720-2957 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2006 |
Last Update Date | 13/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G613280 | (05) | CA |
00G613280 | BS OF CA (01) | CA |
F23033 | (02) |