Individual
AL V TAIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 S SAN MATEO DR, SAN MATEO, CA 94401-3805
(650) 696-4509
Mailing address
325 DISTEL CIR, LOS ALTOS, CA 94022-1408
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
A111479
CA
2085R0001X
Radiation Oncology Physician
ML20008759
WA
Other
Enumeration date
10/19/2006
Last updated
02/20/2020
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