Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | G22010 | CA |
NPI | 1104847656 |
---|---|
Provider Name | Dr. Richard W Starrett |
First Address | San Jose, CA 95124-4002 |
Second Address | San Jose, CA 95124-4002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 12/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G220100 | (05) | CA |
756021161 | RAILROAD MEDICARE PIN (01) | CA |
A41451 | (02) | CA |