Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | A96657 | CA |
NPI | 1205025996 |
---|---|
Provider Name | Dr. Maria Delie Ty Jumagdao-Sakai |
First Address | Gilroy, CA 95020 |
Second Address | Gilroy, CA 95020-3536 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2007 |
Last Update Date | 21/06/2011 |