Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 103762 | CA |
N | 1223P0300X | Periodontist | 33792 | TX |
NPI | 1134623523 |
---|---|
Provider Name | Nathan Daniel Palanker |
First Address | Sunnyvale, CA 94087-5250 |
Second Address | San Leandro, CA 94577-4838 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2018 |
Last Update Date | 13/12/2021 |