Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | G57474 | CA |
Y | 207QA0401X | Family Doctor - Addiction Medicine | G57474 | CA |
N | 207R00000X | Internist | G57474 | CA |
N | 111NI0900X | Internist | G57474 | CA |
NPI | 1699844621 |
---|---|
Provider Name | Francisco S. Pardo |
First Address | San Diego, CA 92110-2126 |
Second Address | San Diego, CA 92101 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2006 |
Last Update Date | 20/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G574740 | (05) | CA |
00G574740 | BLUE SHIELD (01) | CA |
E97273 | (02) | CA |