Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | 23729 | CA |
NPI | 1497060503 |
---|---|
Provider Name | Christine Jinkyoung An |
First Address | Los Angeles, CA 90006-1006 |
Second Address | Los Angeles, CA 90006 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2010 |
Last Update Date | 12/08/2010 |