Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | G71797 | CA |
NPI | 1114069069 |
---|---|
Provider Name | Dr. Cynthia Joyce Kapphahn |
First Address | Mountain View, CA 94040-2570 |
Second Address | Mountain View, CA 94040-2570 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G717970 | (05) | CA |
E64829 | (02) | CA |