Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | A69788 | CA |
NPI | 1003917147 |
---|---|
Provider Name | Dr. Gina L Sulmeyer |
First Address | Torrance, CA 90505-5002 |
Second Address | Torrance, CA 90505-5002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2006 |
Last Update Date | 09/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
930109931 | MEDICARE RAILROAD PIN (01) | CA |
H38037 | (02) | CA |