Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | G84379 | CA |
Y | 111NI0900X | Internist | G84379 | CA |
N | 207RI0200X | Infectious Disease | G84379 | CA |
NPI | 1003872870 |
---|---|
Provider Name | Dr. Malcolm D John |
First Address | San Francisco, CA 94143-0001 |
Second Address | San Francisco, CA 94143-2202 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2006 |
Last Update Date | 30/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G843790 | (05) | CA |
H30189 | (02) | CA |