Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | A40272 | CA |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | A40272 | CA |
NPI | 1295734721 |
---|---|
Provider Name | Robert Del Junco |
First Address | Orange, CA 92863-5971 |
Second Address | Orange, CA 92868-4225 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2005 |
Last Update Date | 15/08/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A402720 | (05) | CA |
040009587 | RAILROAD MEDICARE (01) | |
040017806 | RAILROAD MEDICARE (01) | |
D34085 | (02) |