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Individual
VICTOR SOUZA
Active
Individual
VICTOR SOUZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A56102
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A561020
BLUE SHIELD
CA
05
—
00A561020
—
CA
Enumeration date
10/14/2005
Last updated
05/26/2015
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