Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | G030406 | CA |
NPI | 1912445438 |
---|---|
Provider Name | Terry Jonathan Perkins |
First Address | Santa Barbara, CA 93105-3878 |
Second Address | Santa Barbara, CA 93105-3878 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2017 |
Last Update Date | 03/02/2017 |