Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | G39501 | CA |
NPI | 1013066018 |
---|---|
Provider Name | Martin F. Ernster |
First Address | San Francisco, CA 94118-1701 |
Second Address | San Francisco, CA 94118-1701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G39501 | STATE MEDICAL LICENSE # (01) | CA |