Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | A101090 | CA |
NPI | 1245413103 |
---|---|
Provider Name | Ann Marie Visosky |
First Address | Pasadena, CA 91188-0001 |
Second Address | Los Angeles, CA 90034-1702 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2007 |
Last Update Date | 02/12/2021 |