Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 61173 | CA |
N | 1223D0001X | Dental Public Health | 159 | HI |
NPI | 1518266949 |
---|---|
Provider Name | Sheila Nguyen |
First Address | San Francisco, CA 94143-0001 |
Second Address | San Francisco, CA 94143-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2011 |
Last Update Date | 02/07/2012 |