Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | A78803 | CA |
NPI | 1124133111 |
---|---|
Provider Name | Dr. Maryam Ziaie Matin |
First Address | San Francisco, CA 94109-3491 |
Second Address | Greenbrae, CA 94904-1901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2006 |
Last Update Date | 10/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H99213 | (02) |