Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 161557 | CA |
NPI | 1003349135 |
---|---|
Provider Name | Rebecca Olveda |
First Address | San Francisco, CA 94143-2549 |
Second Address | San Francisco, CA 94143-2549 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2017 |
Last Update Date | 02/05/2019 |