Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | G81296 | CA |
NPI | 1023192093 |
---|---|
Provider Name | Scott M. Trahms |
First Address | Oakland, CA 94612-3466 |
Second Address | Santa Rosa, CA 95403-2149 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 06/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G812960 | (05) | CA |
F56647 | (02) |