Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | A94219 | CA |
Y | 2080P0205X | Pediatric Endocrinologist | A94219 | CA |
NPI | 1255579371 |
---|---|
Provider Name | Christina Southern Reh |
First Address | Orange, CA 92868-3835 |
Second Address | Orange, CA 92868-3835 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2009 |
Last Update Date | 14/03/2012 |