Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 20A44620 | CA |
N | 207VG0400X | Gynecologist | 20A44620 | CA |
N | 207VX0000X | Obstetrician | 20A44620 | CA |
NPI | 1417951310 |
---|---|
Provider Name | Paul Arthur Pyka |
First Address | La Mesa, CA 91942-3099 |
Second Address | La Mesa, CA 91942-3099 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2005 |
Last Update Date | 24/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00AX44620 | (05) | CA |
A93582 | (02) |