Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | E-1936 | CA |
NPI | 1144307893 |
---|---|
Provider Name | Dr. Edwin Francis Houtkooper |
First Address | San Francisco, CA 94123-1407 |
Second Address | San Francisco, CA 94123-1407 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 08/07/2007 |