Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | A50002 | CA |
NPI | 1356341671 |
---|---|
Provider Name | Robert Francisco Letamendi |
First Address | Watsonville, CA 95076-4337 |
Second Address | Watsonville, CA 95076-4337 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A500020 | (05) | CA |
F-48642 | (02) | CA |