Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | G88168 | CA |
NPI | 1134301906 |
---|---|
Provider Name | Hugh O'brodovich |
First Address | Palo Alto, CA 94303-3341 |
Second Address | Stanford, CA 94305-2200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2007 |
Last Update Date | 13/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G88168 | MEDICAL LICENSE (01) | CA |