Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207T00000X | Neurosurgeon | PA17461 | CA |
NPI | 1124043138 |
---|---|
Provider Name | Niloufar Gabbay |
First Address | Emeryville, CA 94608-1826 |
Second Address | Emeryville, CA 94608-1826 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 26/11/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PA17461 | (05) | CA |
Q30008 | (02) | CA |