Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | A60605 | CA |
N | 207ND0101X | MOHS-Micrographic Surgeon | A60605 | CA |
N | 207ND0900X | Dermatopathologist | A60605 | CA |
N | 207NS0135X | Procedural Dermatology | A60605 | CA |
NPI | 1346341252 |
---|---|
Provider Name | Carie Tze-Wan Chui |
First Address | San Mateo, CA 94401-3915 |
Second Address | San Mateo, CA 94401-3915 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2006 |
Last Update Date | 25/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G96336 | (02) | CA |