Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | G58290 | CA |
NPI | 1265467708 |
---|---|
Provider Name | Dr. Janet Roberta Kallo |
First Address | Toledo, OH 43614-1509 |
Second Address | San Francisco, CA 94117-1019 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 24/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E79717 | (02) | CA |