Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | A66496 | CA |
NPI | 1053371559 |
---|---|
Provider Name | Dr. Robert Ra Nien Tseng |
First Address | Daly City, CA 94015 |
Second Address | Daly City, CA 94015 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2006 |
Last Update Date | 26/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A664960 | (05) | CA |
00A664961 | BLUE SHIELD (01) | CA |
H17882 | (02) |