Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VG0400X | Gynecologist | A100716 | CA |
Y | 207VX0201X | Gynecologic Oncologist | A100716 | CA |
NPI | 1093909228 |
---|---|
Provider Name | Dr. Amy A Hakim |
First Address | Los Angeles, CA 90051-0185 |
Second Address | Palm Springs, CA 92262-4800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2007 |
Last Update Date | 29/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A100716 | THE MEDICAL BOARD OF CA (01) | CA |
E2021158 | DEPT. OF MOTOR VEHICLES (01) | CA |