Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | G38271 | CA |
NPI | 1013097013 |
---|---|
Provider Name | Dr. Ricki Pollycove |
First Address | San Francisco, CA 94115-2373 |
Second Address | San Francisco, CA 94115-2373 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 08/07/2007 |