Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | C41444 | CA |
Y | 207RX0202X | Medical Oncology | C41444 | CA |
NPI | 1184669285 |
---|---|
Provider Name | Ricardo Da Roza |
First Address | Pleasanton, CA 94588-4054 |
Second Address | Castro Valley, CA 94546-5331 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2006 |
Last Update Date | 01/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00C414440 | (05) | CA |
110041014 | RAILROAD MEDICARE (01) | |
E92525 | (02) |