Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | G24948 | CA |
NPI | 1174543318 |
---|---|
Provider Name | Andrew Saxon |
First Address | Los Angeles, CA 90095-1690 |
Second Address | Los Angeles, CA 90095 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 02/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1174543318 | (05) | CA |
1174543318 | CCS PANELED (01) | CA |
A90906 | (02) | CA |