Individual
LORY DAVID WIVIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2100 WEBSTER ST, #404, SAN FRANCISCO, CA 94115-2373
(415) 923-3883
Mailing address
54 MARTHA AVE, SAN FRANCISCO, CA 94131-2835
(415) 469-0643
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
G0557430
CA
Other
Enumeration date
02/22/2007
Last updated
07/08/2007
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