Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | G12959 | CA |
NPI | 1982633129 |
---|---|
Provider Name | Sheldon Solomon Kabaker |
First Address | Oakland, CA 94609 |
Second Address | Oakland, CA 94609 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2006 |
Last Update Date | 17/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G129590 | (05) | CA |
A38847 | (02) | |
A38847 | (02) | CA |