Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | G37035 | CA |
NPI | 1023070430 |
---|---|
Provider Name | Tak Poon |
First Address | Burlingame, CA 94010-2048 |
Second Address | Burlingame, CA 94010-4506 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2006 |
Last Update Date | 11/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G37035 | STATE LICENSE # (01) | CA |