Provider Demographics
NPI:1588660740
Name:WHITCOMB, NED J (MD)
Entity Type:Individual
Prefix:
First Name:NED
Middle Name:J
Last Name:WHITCOMB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3609 MISSION AVE
Mailing Address - Street 2:STE A
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-2955
Mailing Address - Country:US
Mailing Address - Phone:916-972-1888
Mailing Address - Fax:916-972-7339
Practice Address - Street 1:3609 MISSION AVE
Practice Address - Street 2:STE A
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-2955
Practice Address - Country:US
Practice Address - Phone:916-972-1888
Practice Address - Fax:916-972-7339
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-22
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC28868207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA33770Medicare UPIN
ME00C288680Medicare PIN