Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | A42776 | CA |
Y | 2080P0205X | Pediatric Endocrinologist | A42776 | CA |
NPI | 1063440980 |
---|---|
Provider Name | Dr. Stephen E. Gitelman |
First Address | San Francisco, CA 94143-0001 |
Second Address | San Francisco, CA 94143-2205 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 13/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A427760 | (05) | CA |
E54818 | (02) | CA |