Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 23663 | CA |
NPI | 1134536295 |
---|---|
Provider Name | Jonathan Pascual |
First Address | San Francisco, CA 94143-2204 |
Second Address | San Francisco, CA 94143-2204 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2014 |
Last Update Date | 21/07/2014 |