Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 28442 | CA |
NPI | 1841381753 |
---|---|
Provider Name | Dr. Jeffrey T Fujimoto |
First Address | San Francisco, CA 94116-1953 |
Second Address | San Francisco, CA 94116-1953 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2006 |
Last Update Date | 08/07/2007 |