Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1100X | Ophthalmic |
NPI | 1891022257 |
---|---|
Provider Name | Mr. William Richard Whitten JR. |
First Address | San Francisco, CA 94121-1545 |
Second Address | San Francisco, CA 94121-1545 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/11/2009 |
Last Update Date | 05/11/2009 |