Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 32687 | CA |
NPI | 1063579670 |
---|---|
Provider Name | Thomas Steven Adamich |
First Address | Huntington Beach, CA 92648-1936 |
Second Address | Huntington Beach, CA 92648-1936 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2007 |
Last Update Date | 08/07/2007 |