Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 95014533 | CA |
NPI | 1306446091 |
---|---|
Provider Name | Candace Maglinao |
First Address | Torrance, CA 90503-4254 |
Second Address | Torrance, CA 90503-4254 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/10/2020 |
Last Update Date | 30/10/2020 |