Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | C33104 | CA |
NPI | 1013079110 |
---|---|
Provider Name | Russell D Woo |
First Address | San Francisco, CA 94115-2382 |
Second Address | San Francisco, CA 94115-2382 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2006 |
Last Update Date | 08/07/2007 |