Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | A41593 | CA |
NPI | 1093795684 |
---|---|
Provider Name | Ajanta Naidu |
First Address | Rancho Palos Verdes, CA 90275-5117 |
Second Address | Orange, CA 92868 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2006 |
Last Update Date | 24/12/2007 |