Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | G24095 | CA |
NPI | 1689786923 |
---|---|
Provider Name | Dr. Betty Miller-Kolotkin |
First Address | Daly City, CA 94015-2228 |
Second Address | Daly City, CA 94015-2228 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F09876 | (02) | CA |