Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | A88345 | CA |
NPI | 1043386527 |
---|---|
Provider Name | Rebecca L. Shpall |
First Address | Los Altos, CA 94022-1408 |
Second Address | Fremont, CA 94538-2299 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2006 |
Last Update Date | 26/05/2020 |