Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 138808 | CA |
N | 208000000X | Pediatrician | MD207111 | LA |
N | 2080P0201X | Pediatric Allergist | 207111 | LA |
N | 2080P0201X | Pediatric Allergist | A138808 | CA |
NPI | 1972802130 |
---|---|
Provider Name | Dr. Barbara Ann Brunet |
First Address | Mission Hills, CA 91346-9602 |
Second Address | Santa Clarita, CA 91387 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2011 |
Last Update Date | 24/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2149989 | (05) | LA |