Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | G43394 | CA |
NPI | 1487725453 |
---|---|
Provider Name | Ann S. Mighell |
First Address | Anaheim, CA 92807-3028 |
Second Address | Anaheim, CA 92807-3028 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 23/09/2008 |