Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 10698 | ND |
N | 208000000X | Pediatrician | A53455 | CA |
N | 2080N0001X | Neonatal-Perinatal Doctor | 10698 | ND |
Y | 2080N0001X | Neonatal-Perinatal Doctor | A53455 | CA |
N | 2080P0202X | Pediatric Cardiologist | 10698 | ND |
N | 2080P0202X | Pediatric Cardiologist | A53455 | CA |
NPI | 1033303268 |
---|---|
Provider Name | Patricio Fernandez-Martorell |
First Address | San Diego, CA 92123-4223 |
Second Address | San Diego, CA 92123-4223 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2007 |
Last Update Date | 20/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1452857 | (05) | ND |