Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 00A288820 | CA |
Y | 208600000X | Surgeon | 00A288820 | CA |
N | 2086S0129X | Vascular Surgeon | 00A288820 | CA |
NPI | 1174506661 |
---|---|
Provider Name | Ralph G Dreier |
First Address | Hemet, CA 92543-4437 |
Second Address | Hemet, CA 92543-4437 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2005 |
Last Update Date | 30/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3571616 | (05) | CA |
CO3869 | (02) | CA |