Stephen Licata M.D.

NPI 1720190580 - Anesthesiology - 207L00000X

NPI Details
NPI 1720190580
Gender Male
Enumeration Date 08/31/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
250 BON AIR RD
GREENBRAE CA, 94904-1702, US
Phone (415) 925-7000
Fax
Business Location
250 BON AIR RD
GREENBRAE CA, 94904, US
Phone (415) 925-7000
Fax
Toxanomy
Taxonomy Code 207L00000X
License State California
License Number G80519
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According to our database, Stephen Licata M.D. NPI is 1720190580, taxonomy code is 207L00000X and license number is G80519, license state is located at California. Stephen Licata M.D. physically located at 250 Bon Air Rd, Greenbrae CA, 94904-1702. NPI Number Stephen Licata M.D. has the Individual type.

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1720190580 NPI number is provided on an as is basis without warranty of any kind. 1720190580 is maintained by the National Plan & Provider Enumeration System. The contents of Stephen Licata M.D. are for informational purposes only.