Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | G072518 | CA |
N | 207VX0000X | Obstetrician | G072518 | CA |
NPI | 1013900653 |
---|---|
Provider Name | Dr. Elisa E. Horta |
First Address | Davis, CA 95616-6204 |
Second Address | Davis, CA 95616-6204 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2005 |
Last Update Date | 24/07/2009 |