Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | G46483 | CA |
N | 2080P0203X | Pediatric Critical Care Doctor | G46483 | CA |
NPI | 1003838327 |
---|---|
Provider Name | John T Tsukahara |
First Address | Sacramento, CA 95865-4947 |
Second Address | San Francisco, CA 94115-1932 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 26/02/2016 |