Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0003X | Hematology & Oncology | 036115134 | IL |
Y | 207RX0202X | Medical Oncology | A49254 | CA |
NPI | 1003883562 |
---|---|
Provider Name | Dr. Diane J Prager |
First Address | Los Angeles, CA 90051-0185 |
Second Address | Torrance, CA 90503-4009 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2006 |
Last Update Date | 28/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G51438 | (02) |