Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | G062221 | CA |
NPI | 1740376607 |
---|---|
Provider Name | Michael Echavez |
First Address | San Francisco, CA 94102-1107 |
Second Address | San Francisco, CA 94102-1107 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 21/12/2011 |