Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | G70242 | CA |
NPI | 1043247661 |
---|---|
Provider Name | Dr. Cathy Weiss Green |
First Address | Santa Monica, CA 90404-2080 |
Second Address | Santa Monica, CA 90404-2080 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 08/07/2007 |