Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | G73590 | CA |
NPI | 1407127657 |
---|---|
Provider Name | Dr. Francis Gerard D'ambrosio |
First Address | Malibu, CA 90265-5036 |
Second Address | Los Angeles, CA 90024-2507 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2012 |
Last Update Date | 03/01/2014 |