Individual
BEN ARNOLD ADOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
95042846
CA
207Q00000X
Family Medicine Physician
95021179
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1417473034
FAMILY PRACTICE
CA
Enumeration date
08/15/2017
Last updated
08/09/2023
Update your record
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