Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 20A7678 | CA |
NPI | 1043215502 |
---|---|
Provider Name | Dr. Alfredo B. Tiu |
First Address | San Diego, CA 92103-9001 |
Second Address | San Diego, CA 92103-9001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2005 |
Last Update Date | 27/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H23300 | (02) | CA |