Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | A60704 | CA |
NPI | 1336244623 |
---|---|
Provider Name | Suruchi Bhatia |
First Address | San Francisco, CA 94118-1618 |
Second Address | San Francisco, CA 94118-1618 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2006 |
Last Update Date | 02/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A60704 | STATE LICENSE (01) | CA |