Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 158015 | CA |
NPI | 1245539964 |
---|---|
Provider Name | Dr. Elizabeth Loudon Profita |
First Address | Palo Alto, CA 94304-1510 |
Second Address | Palo Alto, CA 94304 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2011 |
Last Update Date | 27/08/2018 |