Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 20A13959 | CA |
NPI | 1144458191 |
---|---|
Provider Name | Jaclyn Blaine Taub |
First Address | San Francisco, CA 94158-2261 |
Second Address | San Francisco, CA 94158-2261 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2009 |
Last Update Date | 11/02/2022 |