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 | 207LP2900X | Anesthesiology | Pain Medicine | 54113 | CALIFORNIA | No |
| 2 | 207LP2900X | Anesthesiology | Pain Medicine | 46887 | CALIFORNIA | No |
| 3 | 207LP2900X | Anesthesiology | Pain Medicine | 20A9059 | CALIFORNIA | No |
| 4 | 207XX0005X | Orthopaedic Surgery | Sports Medicine | 116163 | CALIFORNIA | No |
| 5 | 207YS0123X | Otolaryngology | Facial Plastic Surgery | A115735 | CALIFORNIA | No |
| 6 | 207YX0905X | Otolaryngology | Otolaryngology/Facial Plastic Surgery | 78758 | CALIFORNIA | No |
| 7 | 2086S0122X | Surgery | Plastic and Reconstructive Surgery | A82791 | CALIFORNIA | No |
| 8 | 2086S0122X | Surgery | Plastic and Reconstructive Surgery | 107087 | CALIFORNIA | No |
| 9 | 2086S0122X | Surgery | Plastic and Reconstructive Surgery | 94269 | CALIFORNIA | No |
| 10 | 2086S0122X | Surgery | Plastic and Reconstructive Surgery | 94061 | CALIFORNIA | No |
| 11 | 2086S0122X | Surgery | Plastic and Reconstructive Surgery | 104427 | CALIFORNIA | Yes |
