Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | A124996 | CA |
NPI | 1013228154 |
---|---|
Provider Name | Danielle Elizabeth Fernandes |
First Address | Los Angeles, CA 90027-6062 |
Second Address | Los Angeles, CA 90066-7032 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2010 |
Last Update Date | 31/03/2021 |