Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | A262980 | CA |
NPI | 1104214196 |
---|---|
Provider Name | Dr. Estrellita Rubio Reyes |
First Address | Los Angeles, CA 90004 |
Second Address | Los Angeles, CA 90004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/12/2014 |
Last Update Date | 30/12/2014 |