Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0201X | Internist - Allergy & Immunology | G71854 | CA |
Y | 207RP1001X | Pulmonary Disease | G71854 | CA |
NPI | 1912959925 |
---|---|
Provider Name | Abraham M Ishaaya |
First Address | Beverly Hills, CA 90210-4303 |
Second Address | Los Angeles, CA 90036-4663 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 26/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G718541 | (05) | CA |
WG71854G | (02) | CA |