Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | C35198 | CA |
NPI | 1215099882 |
---|---|
Provider Name | Dr. Joseph F Haggerty |
First Address | San Francisco, CA 94117-1016 |
Second Address | San Francisco, CA 94117-1016 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2006 |
Last Update Date | 29/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00C351980 | (05) | CA |
F08155 | (02) | CA |