Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | ||
Y | 222Z00000X | Podiatrist | ||
N | 224P00000X | Prosthetist |
NPI | 1245228428 |
---|---|
Provider Name | Toby D Janowitz |
First Address | Palmdale, CA 93551-4487 |
Second Address | Palmdale, CA 93551-4487 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2005 |
Last Update Date | 03/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
XC0153290 | (05) | CA |
ZZZ39886Z | BLUE SHIELD (01) | CA |