Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | G084894 | CA |
NPI | 1003922691 |
---|---|
Provider Name | Dr. Michael T Furlong |
First Address | San Jose, CA 95131-2019 |
Second Address | San Jose, CA 95131-2019 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2006 |
Last Update Date | 21/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G55429 | (02) | CA |