Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 54025 | CA |
NPI | 1447573779 |
---|---|
Provider Name | Mr. Darvin Charles Foo |
First Address | Sacramento, CA 95817-2215 |
Second Address | Sacramento, CA 95817-2215 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2010 |
Last Update Date | 23/04/2019 |