Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 33967 | CA |
NPI | 1437672060 |
---|---|
Provider Name | Dr. Rosemarie Caigoy |
First Address | San Leandro, CA 94577-4810 |
Second Address | San Leandro, CA 94577-4810 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2017 |
Last Update Date | 25/07/2017 |