Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 20A15248 | CA |
Y | 2080P0216X | Pediatric Rheumatologist | 20A15248 | CA |
NPI | 1275987364 |
---|---|
Provider Name | Dr. Aileen Marie Dickinson |
First Address | Orange, CA 92868-4203 |
Second Address | Orange, CA 92868-4203 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2016 |
Last Update Date | 18/10/2021 |