Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | G25519 | CA |
Y | 2084N0402X | Child Neurologist | G25519 | CA |
NPI | 1124051420 |
---|---|
Provider Name | Dr. Doris Ann Trauner |
First Address | San Diego, CA 92123-4802 |
Second Address | San Diego, CA 92123-2778 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2006 |
Last Update Date | 02/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G255190 | (05) | CA |