Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 20247 | CA |
NPI | 1043724719 |
---|---|
Provider Name | Anna X Liang |
First Address | San Francisco, CA 94116-1308 |
Second Address | Oakland, CA 94609-1809 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2017 |
Last Update Date | 16/11/2017 |