Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | G85709 | CA |
NPI | 1215994918 |
---|---|
Provider Name | Mr. Steve Sommer |
First Address | Monrovia, CA 91017 |
Second Address | Duarte, CA 91010 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G857090 | (05) | CA |
I37663 | (02) |