Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | F362328759 | CA |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | F070519286 | CA |
NPI | 1457750119 |
---|---|
Provider Name | Paul Jeffrey Rainbolt |
First Address | Santa Barbara, CA 93111-2736 |
Second Address | West Hollywood, CA 90048-1804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2014 |
Last Update Date | 30/12/2015 |