Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | G13868 | CA |
NPI | 1164535316 |
---|---|
Provider Name | Dr. Gerald (nmn) Charles |
First Address | San Francisco, CA 94121-1545 |
Second Address | San Francisco, CA 94121-1545 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2006 |
Last Update Date | 08/07/2007 |