Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | G52404 | CA |
N | 111NI0900X | Internist | G52404 | CA |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | G52404 | CA |
N | 207RC0000X | Internist - Cardiovascular Disease | G52404 | CA |
NPI | 1669420956 |
---|---|
Provider Name | Teresa De Marco |
First Address | San Francisco, CA 94143-2204 |
Second Address | San Francisco, CA 94143-2204 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2006 |
Last Update Date | 12/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G524040 | (05) | CA |
D33341 | (02) | CA |