Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A94619 | CA |
N | 111NI0900X | Internist | A94619 | CA |
N | 208000000X | Pediatrician | A94619 | CA |
Y | 2080P0203X | Pediatric Critical Care Doctor | A94619 | CA |
NPI | 1154522340 |
---|---|
Provider Name | Dr. Grace Chan Oei |
First Address | Loma Linda, CA 92350 |
Second Address | Loma Linda, CA 92354-2741 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2007 |
Last Update Date | 31/08/2017 |