Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | DC 20163 | CA |
NPI | 1710995857 |
---|---|
Provider Name | Dr. Ronald R Desmarais |
First Address | South San Francisco, CA 94080-5988 |
Second Address | South San Francisco, CA 94080-5988 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U20672 | (02) | CA |