Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | G035357 | CA |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | G035457 | CA |
NPI | 1588730345 |
---|---|
Provider Name | Dr. Bonita A Palmer |
First Address | San Francisco, CA 94110-2301 |
Second Address | San Francisco, CA 94110-2301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/11/2006 |
Last Update Date | 28/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G354570 | (05) | CA |
2018023 | (05) | CA |
94-3124827 | EMPLOYER IDENTIFICATION # (01) | CA |
A46363 | (02) | CA |