Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | G43959 | CA |
NPI | 1003964826 |
---|---|
Provider Name | Dr. Wing K Kam |
First Address | San Francisco, CA 94143-0001 |
Second Address | San Francisco, CA 94118-1504 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E88492 | (02) | CA |