Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | G88099 | CA |
N | 207RX0202X | Medical Oncology | 25312 | WI |
NPI | 1023084035 |
---|---|
Provider Name | Paul R Kaesberg |
First Address | Sacramento, CA 95817-2229 |
Second Address | Sacramento, CA 95817-2229 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2006 |
Last Update Date | 29/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
31376900 | (05) | WI |
B53959 | (02) |