Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 02983 | CA |
Y | 222Z00000X | Podiatrist | 02983 | CA |
N | 224P00000X | Prosthetist | 02983 | CA |
NPI | 1033705504 |
---|---|
Provider Name | Ms. Natalie Sooja Bacha |
First Address | San Francisco, CA 94121-1563 |
Second Address | San Francisco, CA 94121-1563 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/12/2020 |
Last Update Date | 17/12/2020 |