Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | G57320 | CA |
NPI | 1023182060 |
---|---|
Provider Name | Dr. Terri Ann Slagle |
First Address | San Francisco, CA 94118-1502 |
Second Address | San Francisco, CA 94118-1502 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G75320 | (05) | CA |
A53265 | (02) | CA |