Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A104399 | CA |
N | 111NI0900X | Internist | A104399 | CA |
N | 207RC0000X | Internist - Cardiovascular Disease | A104399 | CA |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | A104399 | CA |
NPI | 1003934449 |
---|---|
Provider Name | Dr. Sujoya Dey |
First Address | Larkspur, CA 94939-1141 |
Second Address | Larkspur, CA 94939-1141 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2007 |
Last Update Date | 16/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4301080717 | MICHIGAN MEDICAL LICENSE (01) | MI |
A 104399 | CALIFORNIA MEDICAL BOARD LICENSE NUMBER (01) | CA |