Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | C174197 | CA |
N | 207VX0201X | Gynecologic Oncologist | 270449 | NY |
NPI | 1326346065 |
---|---|
Provider Name | Ana Isabel Tergas |
First Address | Los Angeles, CA 90051-0185 |
Second Address | Duarte, CA 91010-3012 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/03/2011 |
Last Update Date | 09/08/2021 |