Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | G57633 | CA |
NPI | 1942381785 |
---|---|
Provider Name | Kathryn Obana |
First Address | Mountain View, CA 94040-6201 |
Second Address | Mountain View, CA 94040-2833 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 06/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F16598 | (02) | CA |