Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 104030 | CA |
NPI | 1740528280 |
---|---|
Provider Name | Maria Leticia Ferreira Cabido |
First Address | San Francisco, CA 94103 |
Second Address | San Francisco, CA 94103-2919 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2013 |
Last Update Date | 14/07/2021 |