Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | G65169 | CA |
NPI | 1508810763 |
---|---|
Provider Name | Jan Todd Rydfors |
First Address | Redwood City, CA 94063-1433 |
Second Address | Redwood City, CA 94063-1433 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2006 |
Last Update Date | 24/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G651690 | (05) | CA |
F03406 | (02) | CA |