Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | G39379 | CA |
NPI | 1245448588 |
---|---|
Provider Name | Dr. James G Garrick |
First Address | San Francisco, CA 94109-4806 |
Second Address | San Francisco, CA 94109-4806 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G393790 | (05) | CA |
A47803 | (02) | CA |