Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | G23728 | CA |
NPI | 1043285737 |
---|---|
Provider Name | Dr. James C. Piepergerdes |
First Address | San Francisco, CA 94108-4206 |
Second Address | San Francisco, CA 94108-4206 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2006 |
Last Update Date | 12/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A42049 | (02) |