Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | G83486 | CA |
NPI | 1043273485 |
---|---|
Provider Name | Janice D Janas |
First Address | San Francisco, CA 94160-0001 |
Second Address | Menco Park, CA 94025-4429 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2006 |
Last Update Date | 20/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G80386 | (02) | |
MMM00087M | NHIC (01) |