Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | A38674 | CA |
NPI | 1073687380 |
---|---|
Provider Name | Plamen V. Yosifov |
First Address | Oakland, CA 94612-3429 |
Second Address | Fresno, CA 93720-2941 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A386740 | (05) | CA |
C76134 | (02) |