Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | G28868 | CA |
NPI | 1053358531 |
---|---|
Provider Name | Sydney C Choslovsky |
First Address | San Jose, CA 95112-6207 |
Second Address | San Jose, CA 95112-6207 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2006 |
Last Update Date | 03/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A43890 | (02) | CA |
GR0016700 | (05) | CA |