Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 12229557-1205 | UT |
N | 111NI0900X | Internist | 12229557-1205 | UT |
NPI | 1003310947 |
---|---|
Provider Name | Thomas Dean Goslinga |
First Address | San Francisco, CA 94143-2204 |
Second Address | San Francisco, CA 94143-2204 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2018 |
Last Update Date | 02/11/2021 |