Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | C52306 | CA |
N | 111NI0900X | Internist | C52306 | CA |
N | 207SG0201X | Clinical Genetics (M.D.) | C52306 | CA |
NPI | 1437183092 |
---|---|
Provider Name | Dr. Robert L Nussbaum |
First Address | San Francisco, CA 94143-2205 |
Second Address | San Francisco, CA 94143-2205 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
HSP40454G | (05) | CA |