Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 50538 | CA |
NPI | 1043594328 |
---|---|
Provider Name | Dr. Anat Tadir |
First Address | Norwalk, CA 90650-4005 |
Second Address | Norwalk, CA 90650-4005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2011 |
Last Update Date | 05/10/2011 |