Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | E2155 | CA |
NPI | 1376523134 |
---|---|
Provider Name | Nina Shliapnikoff Todd |
First Address | San Francisco, CA 94118-1031 |
Second Address | San Francisco, CA 94118-1031 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2006 |
Last Update Date | 16/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000E21550 | (05) | CA |
T11206 | (02) | CA |