Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | 056566 | NY |
N | 213EG0000X | General Practice | 056566 | NY |
N | 1223G0001X | General Practice | 101209 | CA |
N | 213EG0000X | General Practice | 101209 | CA |
N | 1223P0106X | Oral and Maxillofacial Pathology | 056566 | NY |
Y | 1223P0106X | Oral and Maxillofacial Pathology | 101209 | CA |
NPI | 1427360940 |
---|---|
Provider Name | Dr. Jill Marie White |
First Address | San Francisco, CA 94121-1563 |
Second Address | San Francisco, CA 94121 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2010 |
Last Update Date | 07/08/2018 |