Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | G16385 | CA |
NPI | 1003870080 |
---|---|
Provider Name | Albert Victor Assali |
First Address | Fremont, CA 94538 |
Second Address | Fremont, CA 94538 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2006 |
Last Update Date | 23/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
05D0662385 | CLIA (01) | |
05D0662385 | CMS (01) | |
9207817 | (05) | CA |
A39784 | (02) | |
AA4299269 | DEA (01) | |
AA4299269 | DEPT OF JUSTICE CTRLD SUB (01) |