Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RX0202X | Medical Oncology | 242984 | NY |
Y | 207RX0202X | Medical Oncology | A119835 | CA |
NPI | 1093861346 |
---|---|
Provider Name | Dr. Trever Bivona |
First Address | San Francisco, CA 94115 |
Second Address | San Francisco, CA 94115 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2007 |
Last Update Date | 20/03/2019 |