Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | G43724 | CA |
NPI | 1073586905 |
---|---|
Provider Name | Mr. Robert Mccabe |
First Address | Livermore, CA 94550-5928 |
Second Address | Pleasanton, CA 94566-6175 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2006 |
Last Update Date | 10/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F24170 | (02) |