Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | C40028 | CA |
NPI | 1013953256 |
---|---|
Provider Name | Dr. A. Eugene Washington |
First Address | San Francisco, CA 94143-0001 |
Second Address | San Francisco, CA 94115-3006 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00C400280 | (05) | CA |
E25285 | (02) | CA |