Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MT326346 | PA |
N | 111NI0900X | Internist | MT326346 | PA |
Y | 207RA0401X | Internist - Addiction Medicine | A173657 | CA |
NPI | 1972090280 |
---|---|
Provider Name | Steven Tate |
First Address | Palo Alto, CA 94304-1419 |
Second Address | Palo Alto, CA 94304-1419 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2018 |
Last Update Date | 12/07/2021 |