Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | A160608 | CA |
NPI | 1003270463 |
---|---|
Provider Name | Hunter Kegan Holt |
First Address | San Francisco, CA 94132-1256 |
Second Address | San Francisco, CA 94132-1255 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2016 |
Last Update Date | 01/04/2021 |