Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | G83350 | CA |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | G83350 | CA |
NPI | 1003830704 |
---|---|
Provider Name | Per Sandberg |
First Address | Mountain View, CA 94040-6203 |
Second Address | Mountain View, CA 94040-4103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 08/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F94327 | (02) | CA |