Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | G46791 | CA |
NPI | 1023176351 |
---|---|
Provider Name | Barbara J Donnelly |
First Address | San Clemente, CA 92674-1359 |
Second Address | Santa Barbara, CA 93102 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G467910 | (05) | CA |