Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | E2499 | CA |
Y | 222Z00000X | Podiatrist | E2499 | CA |
NPI | 1053453548 |
---|---|
Provider Name | Dr. Michael M Toriumi |
First Address | San Francisco, CA 94123-2505 |
Second Address | San Francisco, CA 94123-2505 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T11362 | (02) |