Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 34589 | CA |
NPI | 1023361581 |
---|---|
Provider Name | Robert Edward Bell |
First Address | Tulare, CA 93274-2251 |
Second Address | Tulare, CA 93274-2251 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/10/2012 |
Last Update Date | 22/10/2012 |