Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | M4370 | TX |
Y | 207V00000X | Obstetrician & Gynecologist | MD60140048 | WA |
N | 207VX0000X | Obstetrician | MD60140048 | WA |
NPI | 1275542672 |
---|---|
Provider Name | Orestes Molina |
First Address | Gig Harbor, WA 98335-1700 |
Second Address | Gig Harbor, WA 98335-1700 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 25/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
182511902 | (05) | TX |
BM9749271 | DEA (01) | TX |
I62027 | (02) | TX |
M4370 | MEDICAL LICENSE (01) | TX |
ME95814 | MEDICAL LICENSE (01) | FL |
P0147658 | DPS (01) | TX |