Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | G67056 | CA |
Y | 207VX0201X | Gynecologic Oncologist | G67056 | CA |
NPI | 1295894673 |
---|---|
Provider Name | Albert Pisani |
First Address | Mountain View, CA 94040-6201 |
Second Address | Mountain View, CA 94040-4124 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2006 |
Last Update Date | 08/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F92519 | (02) | CA |
G067056 | STATE LICENSE (01) | |
W18764 | MEDICARE GROUP (01) | CA |