Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | G61244 | CA |
NPI | 1568514792 |
---|---|
Provider Name | Cathy L. Christian |
First Address | Pacifica, CA 94044-6268 |
Second Address | Pacifica, CA 94044-2152 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2007 |
Last Update Date | 13/03/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G612440 | (05) | CA |
H40634 | (02) |