Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | 20068 | CA |
NPI | 1720013576 |
---|---|
Provider Name | Dr. Warren Leo Cipa |
First Address | Corte Madera, CA 94925 |
Second Address | Corte Madera, CA 94925-1709 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 08/07/2007 |