Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | G38760 | CA |
NPI | 1003827346 |
---|---|
Provider Name | Ruth Rothman |
First Address | Mountain View, CA 94040-6203 |
Second Address | Palo Alto, CA 94301-2302 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2006 |
Last Update Date | 10/01/2012 |