Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | A48424 | CA |
NPI | 1013095926 |
---|---|
Provider Name | Charito P. Sico |
First Address | Oakland, CA 94612-3429 |
Second Address | Daly City, CA 94015-2770 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 01/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A484240 | (05) | CA |
F25963 | (02) |