Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 036-118703 | IL |
NPI | 1003014523 |
---|---|
Provider Name | Antonia Leigh Cotwright |
First Address | Redondo Beach, CA 90277-3032 |
Second Address | Redondo Beach, CA 90277-3032 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2007 |
Last Update Date | 08/12/2021 |