Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | A132322 | CA |
NPI | 1285825018 |
---|---|
Provider Name | Troy I Mounts |
First Address | San Luis Obispo, CA 93406-1737 |
Second Address | Atascadero, CA 93422-2481 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2007 |
Last Update Date | 02/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1548664717 | GROUP NPI (01) | CA |