Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A103746 | CA |
N | 111NI0900X | Internist | A103746 | CA |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | A103746 | CA |
NPI | 1427218973 |
---|---|
Provider Name | Van Nye Selby |
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 | 09/06/2008 |
Last Update Date | 17/12/2021 |