Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0402X | Child Neurologist | 14663 | NH |
N | 2084N0402X | Child Neurologist | 18892 | DC |
NPI | 1295723450 |
---|---|
Provider Name | Stephen Hamilton Mott |
First Address | Santa Ana, CA 92705-5518 |
Second Address | Santa Ana, CA 92705-5518 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2005 |
Last Update Date | 06/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1016783 | (05) | VT |
1295723450 | (05) | CA |
30209003 | (05) | NH |
F80829 | (02) |