Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | AFE24205 | CA |
NPI | 1003152331 |
---|---|
Provider Name | Alma Luna Wells |
First Address | Los Angeles, CA 90029-8319 |
Second Address | Los Angeles, CA 90020-1117 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2012 |
Last Update Date | 13/12/2012 |