Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | A75575 | CA |
NPI | 1134187644 |
---|---|
Provider Name | Howard A Carpenter |
First Address | San Francisco, CA 94115-1925 |
Second Address | San Francisco, CA 94115-1925 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 22/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A755750 | BLUE SHIELD OF CA (01) | CA |
1134187644 | (05) | CA |
I44996 | (02) |