Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports | 33252 | CA |
NPI | 1023228053 |
---|---|
Provider Name | Dr. Michael Vincent Gaddini |
First Address | San Francisco, CA 94134-1422 |
Second Address | San Francisco, CA 94104-3567 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 08/07/2007 |