Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
1 | 207Q00000X | Family Medicine | | 57463 | CALIFORNIA | No |
2 | 207Q00000X | Family Medicine | | 0110007132 | VIRGINIA | No |
3 | 207R00000X | Internal Medicine | | PA031714 | DISTRICT OF COLUMBIA | No |
4 | 207R00000X | Internal Medicine | | 57463 | CALIFORNIA | No |
5 | 207R00000X | Internal Medicine | | 0110007132 | VIRGINIA | No |
6 | 363A00000X | Physician Assistant | | PA031714 | DISTRICT OF COLUMBIA | No |
7 | 363A00000X | Physician Assistant | | 57463 | CALIFORNIA | No |
8 | 363A00000X | Physician Assistant | | 0110007132 | VIRGINIA | No |
9 | 363AM0700X | Physician Assistant | Medical | PA031714 | CALIFORNIA | No |
10 | 363AM0700X | Physician Assistant | Medical | 57463 | CALIFORNIA | No |
11 | 363AM0700X | Physician Assistant | Medical | 0110007132 | VIRGINIA | No |
12 | 207Q00000X | Family Medicine | | PA031714 | DISTRICT OF COLUMBIA | Yes |