Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | A91423 | CA |
Y | 207N00000X | Dermatologist | A914243 | CA |
NPI | 1053750240 |
---|---|
Provider Name | Dr. Sara Whitehead |
First Address | Palo Alto, CA 94302-0068 |
Second Address | Palo Alto, CA 94301-1407 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2013 |
Last Update Date | 01/04/2020 |