Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | A99965 | CA |
Y | 208600000X | Surgeon | A99965 | CA |
N | 2086S0102X | Surgical Critical Care | A99965 | CA |
N | 2086S0127X | Trauma Surgeon | A99965 | CA |
N | 208D00000X | General Practice Physician | A99965 | CA |
NPI | 1023345048 |
---|---|
Provider Name | Dr. Catherine Jeanne Juillard |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Los Angeles, CA 90095-8344 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/11/2009 |
Last Update Date | 26/12/2019 |