Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | A32147 | CA |
NPI | 1659414407 |
---|---|
Provider Name | Erlinda Q. Dizon |
First Address | Oakland, CA 94612-3429 |
Second Address | San Jose, CA 95119-1130 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A321470 | (05) | CA |
F09850 | (02) |