Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | A122141 | CA |
N | 207RC0000X | Internist - Cardiovascular Disease | A122141 | CA |
NPI | 1053593095 |
---|---|
Provider Name | Dr. Eugene Christopher Depasquale |
First Address | Los Angeles, CA 90031-0309 |
Second Address | Los Angeles, CA 90033-5312 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2007 |
Last Update Date | 28/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1053593095 | (05) | CA |