Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | G13143 | CA |
NPI | 1689610537 |
---|---|
Provider Name | Leonard A Valentino |
First Address | Redwood City, CA 94062-1423 |
Second Address | Redwood City, CA 94062-1423 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A38897 | (02) | CA |
G13143 | MEDICAL LICENSE (01) | CA |