Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | EL 1754 | CA |
NPI | 1104065366 |
---|---|
Provider Name | Dr. Jacinta Tu-Tram Sy Do |
First Address | Brisbane, CA 94005-1272 |
Second Address | Brisbane, CA 94005-1272 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2009 |
Last Update Date | 11/02/2009 |