Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | C41731 | CA |
NPI | 1235217902 |
---|---|
Provider Name | Vincent A. Kiley |
First Address | Oakland, CA 94612-3429 |
Second Address | Roseville, CA 95661-3027 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 27/02/2009 |