Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | A154281 | CA |
N | 208600000X | Surgeon | A154281 | CA |
Y | 2086S0102X | Surgical Critical Care | A154281 | CA |
NPI | 1003108531 |
---|---|
Provider Name | Dr. Marissa A Boeck |
First Address | San Francisco, CA 94143-2202 |
Second Address | San Francisco, CA 94143-2202 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2011 |
Last Update Date | 22/09/2020 |