Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | ||
N | 222Z00000X | Podiatrist | ||
Y | 224P00000X | Prosthetist |
NPI | 1386986966 |
---|---|
Provider Name | Albert Becker |
First Address | San Francisco, CA 94145-0342 |
Second Address | San Jose, CA 95128-1478 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2013 |
Last Update Date | 21/03/2013 |