Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | A24862 | CA |
NPI | 1083724306 |
---|---|
Provider Name | Dr. Beverly M Gates |
First Address | Torrance, CA 90503-4354 |
Second Address | Torrance, CA 90503-4354 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 08/07/2007 |