Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | C171909 | CA |
NPI | 1255916896 |
---|---|
Provider Name | Dr. Bridget Ann Fernandez |
First Address | Los Angeles, CA 90031-0309 |
Second Address | Los Angeles, CA 90027-6062 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2021 |
Last Update Date | 19/11/2021 |