Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | G43623 | CA |
NPI | 1467536433 |
---|---|
Provider Name | Kaye R. Fichman |
First Address | Oakland, CA 94612-3429 |
Second Address | San Rafael, CA 94903-3308 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G436230 | (05) | CA |
F24473 | (02) |