Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 41694 | CA |
NPI | 1053435693 |
---|---|
Provider Name | Perry Lynn Westbrook |
First Address | Sunnyvale, CA 94087-2315 |
Second Address | Sunnyvale, CA 94087-2315 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2007 |
Last Update Date | 08/07/2007 |