Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A132224 | CA |
N | 111NI0900X | Internist | A132224 | CA |
Y | 207RR0500X | Rheumatology | A132224 | CA |
NPI | 1104262708 |
---|---|
Provider Name | Brian Tadayoshi Abe |
First Address | Palo Alto, CA 94304-1808 |
Second Address | Stanford, CA 94305-2200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2013 |
Last Update Date | 13/07/2020 |