Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | G079747 | CA |
NPI | 1154329209 |
---|---|
Provider Name | Francisco Abreu Bracho |
First Address | Baltimore, MD 21263-1856 |
Second Address | Ventura, CA 93003-3099 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2005 |
Last Update Date | 28/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G55175 | (02) |