Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207KA0200X | Allergist | G7115 | CA |
Y | 207RA0201X | Internist - Allergy & Immunology | G7115 | CA |
NPI | 1548370521 |
---|---|
Provider Name | Clayton Feldman |
First Address | San Jose, CA 95126-3518 |
Second Address | San Jose, CA 95126-3705 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 10/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000G71150 | (05) | CA |
A57737 | (02) | CA |