Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | A38970 | CA |
NPI | 1023168127 |
---|---|
Provider Name | Dalila B Corry |
First Address | Santa Monica, CA 90403-5229 |
Second Address | Northridge, CA 91325-4108 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2007 |
Last Update Date | 27/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A389700 | (05) | CA |
A28778 | (02) | CA |