Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | A111887 | CA |
NPI | 1003019001 |
---|---|
Provider Name | Ben Chung Li |
First Address | San Francisco, CA 94143-0132 |
Second Address | San Francisco, CA 94143-0132 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2007 |
Last Update Date | 08/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
BP1-0026455 | INSTITUTIONAL PERMIT (01) |