Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | A72746 | CA |
N | 207PE0004X | Emergency Medical Services | A72746 | CA |
NPI | 1043226830 |
---|---|
Provider Name | Reb Julia Haas Close |
First Address | Monterey, CA 93942 |
Second Address | Monterey, CA 93940-5902 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 20/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A727460 | BLUE SHIELD (01) | CA |
H77783 | (02) | CA |
P00032055 | RAILROAD (01) | CA |