Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | A151234 | CA |
NPI | 1013379189 |
---|---|
Provider Name | Gena Damento |
First Address | San Francisco, CA 94102-3272 |
Second Address | San Francisco, CA 94102-3272 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2016 |
Last Update Date | 20/12/2021 |