Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | A79831 | CA |
NPI | 1023083086 |
---|---|
Provider Name | Andrew G Gianoukakis |
First Address | Torrance, CA 90502-2047 |
Second Address | Torrance, CA 90502-2047 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2006 |
Last Update Date | 09/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H06079 | (02) | CA |