Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | G84061 | CA |
NPI | 1013009679 |
---|---|
Provider Name | Frederick D Pitts JR. |
First Address | San Francisco, CA 94103-4003 |
Second Address | San Francisco, CA 94103-4003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2006 |
Last Update Date | 12/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G840610 | (05) | CA |
G84061 | (02) |