Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | G36480 | CA |
NPI | 1073576310 |
---|---|
Provider Name | Gene Victor Sherman |
First Address | Palos Verdes Peninsula, CA 90274-8609 |
Second Address | El Segundo, CA 90245-2825 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2006 |
Last Update Date | 19/11/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G364800 | (05) | CA |
A91788 | (02) |