Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | A82458 | CA |
N | 207PE0004X | Emergency Medical Services | A82458 | WA |
NPI | 1083670475 |
---|---|
Provider Name | Dr. Adria Elene Ottoboni |
First Address | Bakersfield, CA 93306-4018 |
Second Address | Bakersfield, CA 93306-4018 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2006 |
Last Update Date | 03/03/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A824580 | (05) | WA |
I06507 | (02) |