Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | E2118 | CA |
NPI | 1114211786 |
---|---|
Provider Name | Ross Eldon Biederman |
First Address | June Lake, CA 93529 |
Second Address | June Lake, CA 93529 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2011 |
Last Update Date | 01/06/2011 |