Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | G27618 | CA |
NPI | 1023231651 |
---|---|
Provider Name | Sharon A Bogerty |
First Address | San Jose, CA 95128-1811 |
Second Address | San Jose, CA 95128-1811 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2007 |
Last Update Date | 05/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A43423 | (02) | |
G27618 | LICENSE NUMBER (01) | CA |