Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 6252 | KS |
Y | 207VX0000X | Obstetrician | A105245 | CA |
NPI | 1033274238 |
---|---|
Provider Name | Antoinette T Khowong |
First Address | Roseville, CA 95661-2865 |
Second Address | Roseville, CA 95661-2865 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2006 |
Last Update Date | 16/12/2021 |