Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | A44794 | CA |
NPI | 1013095801 |
---|---|
Provider Name | Sally B. Slome |
First Address | Oakland, CA 94611-5641 |
Second Address | Oakland, CA 94611-5641 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 17/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A447940 | (05) | CA |
D44511 | (02) |