Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | A115106 | CA |
N | 207U00000X | Nuclear Medicine Specialist | A115106 | CA |
NPI | 1144506395 |
---|---|
Provider Name | Dr. Ella Yevdayev |
First Address | Long Beach, CA 90804-6926 |
Second Address | Long Beach, CA 90804-6926 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2011 |
Last Update Date | 17/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
FY5507352 | DEA (01) | CA |