Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | G54677 | CA |
N | 2080P0207X | Pediatric Hematology-Oncologist | G54677 | CA |
NPI | 1104997956 |
---|---|
Provider Name | Richard Preston Kadota |
First Address | San Diego, CA 92123-4800 |
Second Address | San Diego, CA 92123-2746 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G546770 | (05) | CA |
H61162 | (02) | CA |