NPI age
19 years
Enumerated 2006-06-16
Across 29 active anesthesiology providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | M9912 | STATE MEDICAL LICENSE |
| 01 (CA) | A74798 | MEDICAL LICENSE |
| 05 (CA) | 00A747980 |
Part of a multi-provider practice. 9 other active providers share this practice address in NPPES.
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