Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | G85915 | CA |
N | 207R00000X | Internist | G85915 | CA |
N | 111NI0900X | Internist | G85915 | CA |
N | 207RC0200X | Critical Care Medicine | G85915 | CA |
NPI | 1053416701 |
---|---|
Provider Name | Rex Scott Adamson |
First Address | Modesto, CA 95357-6649 |
Second Address | Modesto, CA 95351-5002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2006 |
Last Update Date | 01/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G859150 | (05) | CA |
F43849 | (02) | CA |