Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | DC0237330 | CA |
NPI | 1336307370 |
---|---|
Provider Name | Sergio Azzolino |
First Address | San Francisco, CA 94109-2539 |
Second Address | San Francisco, CA 94109-2539 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2008 |
Last Update Date | 10/04/2013 |