Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 43158 | CA |
N | 111NI0900X | Internist | 43158 | CA |
N | 207RX0202X | Medical Oncology | 43158 | CA |
NPI | 1093751562 |
---|---|
Provider Name | Dr. Cary Hajime Gota |
First Address | Los Angeles, CA 90017-4810 |
Second Address | Los Angeles, CA 90017-4810 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G215630 | (05) | CA |
A 41316 | (02) | |
G21563 | CA MEDICAL LICENSE (01) | CA |