Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0000X | Hematologist | G11462 | CA |
NPI | 1174806111 |
---|---|
Provider Name | Dr. Mervyn Allen Sahud |
First Address | Antioch, CA 94531-8811 |
Second Address | Oakland, CA 94612-1743 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2011 |
Last Update Date | 05/04/2012 |