Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | A116018 | CA |
Y | 111NI0900X | Internist | A116018 | CA |
NPI | 1003139445 |
---|---|
Provider Name | Dr. Joseph Patrick Henry |
First Address | San Francisco, CA 94139-0001 |
Second Address | Walnut Creek, CA 94595-2501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2010 |
Last Update Date | 16/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P01451512 | RAILROAD MEDICARE (01) | CA |