Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 36293 | CA |
Y | 213EG0000X | General Practice | 36293 | CA |
NPI | 1003911868 |
---|---|
Provider Name | David Michael Vierhus |
First Address | San Jose, CA 95124-3241 |
Second Address | San Jose, CA 95124-3241 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2006 |
Last Update Date | 12/05/2015 |