Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TH0100X | Health Service | 15689 | CA |
NPI | 1508913781 |
---|---|
Provider Name | Dr. Joshua Lewis Kirz |
First Address | Palo Alto, CA 94304-1709 |
Second Address | Palo Alto, CA 94304-1709 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2007 |
Last Update Date | 08/07/2007 |