Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | G54179 | CA |
NPI | 1174615389 |
---|---|
Provider Name | Dr. Cornelia B Daly |
First Address | Santa Monica, CA 90404-2199 |
Second Address | Santa Monica, CA 90404-2199 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 30/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A93283 | (02) | CA |