Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 253328 | NY |
Y | 207R00000X | Internist | C52495 | CA |
Y | 111NI0900X | Internist | C52495 | CA |
NPI | 1013080167 |
---|---|
Provider Name | Vino K Palli |
First Address | San Francisco, CA 94102-2871 |
Second Address | San Francisco, CA 94102-2871 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2006 |
Last Update Date | 10/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G87537 | (02) | IL |