Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | A91995 | CA |
NPI | 1023044997 |
---|---|
Provider Name | Dr. Viktoriya S Irodenko |
First Address | San Francisco, CA 94122-3759 |
Second Address | San Francisco, CA 94143-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 08/07/2007 |