Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | A42398 | CA |
NPI | 1013931930 |
---|---|
Provider Name | Saad Juma |
First Address | San Diego, CA 92163-3865 |
Second Address | Encinitas, CA 92024-5141 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 18/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A42398 | STATE LICENSE (01) | CA |
E51106 | (02) |