Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-13468 | CA |
NPI | 1114452448 |
---|---|
Provider Name | Angelica Benitez |
First Address | Los Angeles, CA 90057-2216 |
Second Address | Los Angeles, CA 90027-6062 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2017 |
Last Update Date | 24/04/2017 |