Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | G70085 | CA |
NPI | 1013989490 |
---|---|
Provider Name | Mrs. Linda Davis-Reed |
First Address | Chico, CA 95926 |
Second Address | Chico, CA 95926 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2006 |
Last Update Date | 26/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E75105 | (02) | |
G70085 | (05) | CA |