Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | A150877 | CA |
NPI | 1093169831 |
---|---|
Provider Name | Donna Jose |
First Address | Loma Linda, CA 92354-2804 |
Second Address | Whittier, CA 90602-1005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2016 |
Last Update Date | 08/06/2021 |