Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | E1275 | CA |
NPI | 1427022995 |
---|---|
Provider Name | Weldon R Hess |
First Address | Stockton, CA 95202-1409 |
Second Address | Stockton, CA 95202-1409 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E1275 | STATE LICENSE (01) | CA |
T10865 | (02) | CA |
ZZZ73253Z | (05) | CA |