Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | G20568 | CA |
NPI | 1801962360 |
---|---|
Provider Name | William Oppenheim |
First Address | Los Angeles, CA 90095-0001 |
Second Address | Los Angeles, CA 90095-6902 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/11/2006 |
Last Update Date | 14/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G205680 | (05) | CA |
A33442 | (02) | CA |