Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | G71721 | CA |
Y | 111NI0900X | Internist | G71721 | CA |
N | 207RA0401X | Internist - Addiction Medicine | G71721 | CA |
NPI | 1508938887 |
---|---|
Provider Name | Barry David Zevin |
First Address | San Francisco, CA 94102-4506 |
Second Address | San Francisco, CA 94102-4506 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2006 |
Last Update Date | 06/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F46154 | (02) | CA |