Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | G38064 | CA |
NPI | 1205907110 |
---|---|
Provider Name | Anne M. Staveren |
First Address | Los Angeles, CA 90027-6021 |
Second Address | Los Angeles, CA 90027-6021 |
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 |