Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | A117297 | CA |
Y | 207YP0228X | Pediatric Otolaryngology | A117297 | CA |
N | 208200000X | Surgeon | A117297 | CA |
N | 208600000X | Surgeon | A117297 | CA |
NPI | 1073733861 |
---|---|
Provider Name | Alisha West |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Los Angeles, CA 90095 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2007 |
Last Update Date | 14/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0A1172970 | (05) | CA |