Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | G69444 | CA |
NPI | 1003857350 |
---|---|
Provider Name | Steven Gary Vitcov |
First Address | San Francisco, CA 94139-0001 |
Second Address | San Francisco, CA 94118-1618 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2006 |
Last Update Date | 12/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G694440 | (05) | CA |
F52836 | (02) |