Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 60291 | CA |
NPI | 1083894877 |
---|---|
Provider Name | Rina Campbell |
First Address | Pleasant Hill, CA 94523-5605 |
Second Address | Pittsburg, CA 94565-4911 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2007 |
Last Update Date | 20/10/2016 |