Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | A54828 | CA |
NPI | 1053300798 |
---|---|
Provider Name | Dr. Arup Roy-Burman |
First Address | San Francisco, CA 94143-0106 |
Second Address | San Francisco, CA 94143-0106 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2005 |
Last Update Date | 12/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A548280 | (05) | CA |
G23522 | (02) | CA |