Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | G65716 | CA |
NPI | 1184633745 |
---|---|
Provider Name | Robert Bocian |
First Address | Los Altos, CA 94022-1408 |
Second Address | Palo Alto, CA 94301-2302 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 04/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F38437 | (02) | CA |