Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | A122680 | CA |
NPI | 1285925990 |
---|---|
Provider Name | Iris M Otani |
First Address | San Francisco, CA 94143 |
Second Address | San Francisco, CA 94143-2202 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2011 |
Last Update Date | 13/09/2017 |