Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | A066416 | CA |
NPI | 1003982265 |
---|---|
Provider Name | Dr. Liza Aline Shiff |
First Address | San Jose, CA 95128-1472 |
Second Address | San Jose, CA 95128-1472 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G85686 | (02) | CA |