Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | C12676 | CA |
NPI | 1609924240 |
---|---|
Provider Name | Ronald J Gariffo |
First Address | Burlingame, CA 94010-2301 |
Second Address | Burlingame, CA 94010-2301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C12675 | CA LIC# (01) | CA |