Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | A32484 | CA |
NPI | 1003932187 |
---|---|
Provider Name | Sergio Stone |
First Address | Calexico, CA 92231-2847 |
Second Address | Calexico, CA 92231-2847 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A32484 | (05) | CA |