Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207KA0200X | Allergist | C27394 | CA |
Y | 208000000X | Pediatrician | C27394 | CA |
NPI | 1083779359 |
---|---|
Provider Name | Dr. Mitchell C Sollod |
First Address | San Francisco, CA 94132-1909 |
Second Address | San Francisco, CA 94132-1909 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/12/2006 |
Last Update Date | 20/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00C273940 | (05) | CA |
943234237 | FEDERAL TAX IDENT NUMBER (01) | |
A33356 | (02) | CA |