Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | C53065 | CA |
N | 111NI0900X | Internist | C53065 | CA |
Y | 207RN0300X | Nephrologist | C53065 | CA |
NPI | 1043205909 |
---|---|
Provider Name | Dr. Carmen S Slavov |
First Address | Northridge, CA 91325-3583 |
Second Address | Mission Hills, CA 91345-1204 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2005 |
Last Update Date | 28/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00C530650 | (05) | CA |
H29597 | (02) | NJ |