Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 34 | CA |
NPI | 1033657192 |
---|---|
Provider Name | Dr. Shunji Sano |
First Address | San Francisco, CA 94143-2549 |
Second Address | San Francisco, CA 94143-2549 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2017 |
Last Update Date | 08/02/2017 |