Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | G33167 | CA |
NPI | 1326032830 |
---|---|
Provider Name | Dr. Bohdan Alexander Makarewycz |
First Address | San Mateo, CA 94402-2263 |
Second Address | Daly City, CA 94015-2228 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2005 |
Last Update Date | 17/11/2011 |