Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | A162040 | CA |
NPI | 1033597018 |
---|---|
Provider Name | Dr. Craig Antone White |
First Address | Los Angeles, CA 90074-0001 |
Second Address | Loma Linda, CA 92354 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2015 |
Last Update Date | 22/06/2020 |