Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | G394880 | CA |
Y | 208600000X | Surgeon | G394880 | CA |
NPI | 1003916321 |
---|---|
Provider Name | Michael S Oholleran |
First Address | Mountain View, CA 94040-6203 |
Second Address | Redwood City, CA 94065-1173 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2006 |
Last Update Date | 22/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G394880 | (05) | CA |
A89682 | (02) |