Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 23046 | CA |
NPI | 1043639784 |
---|---|
Provider Name | Brittany Masters |
First Address | Santa Monica, CA 90401-2840 |
Second Address | Santa Monica, CA 90401-2840 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2014 |
Last Update Date | 09/04/2014 |