Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | G86242 | CA |
NPI | 1144264581 |
---|---|
Provider Name | Elizabeth Ann Landsverk |
First Address | Burlingame, CA 94010 |
Second Address | Burlingame, CA 94010 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2006 |
Last Update Date | 23/03/2015 |