Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | G75688 | CA |
N | 2080P0203X | Pediatric Critical Care Doctor | G75688 | CA |
NPI | 1285744607 |
---|---|
Provider Name | Dr. Patrick S. Mcquillen |
First Address | San Francisco, CA 94143-0001 |
Second Address | San Francisco, CA 94143-2204 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 22/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G756880 | (05) | CA |
G63821 | (02) | CA |