Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | E5394 | CA |
Y | 222Z00000X | Podiatrist | E5394 | CA |
N | 213EP1101X | Primary Podiatric Medicine | E5394 | CA |
N | 213ES0103X | Foot & Ankle Surgery | E5394 | CA |
N | 213ES0131X | Foot Surgery | E5394 | CA |
NPI | 1154766475 |
---|---|
Provider Name | Adrienne Estes |
First Address | Pomona, CA 91766-2007 |
Second Address | Pomona, CA 91766-2007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2013 |
Last Update Date | 17/03/2018 |