Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | G77962 | CA |
N | 208600000X | Surgeon | G77962 | CA |
Y | 2086S0127X | Trauma Surgeon | G77962 | CA |
NPI | 1104838663 |
---|---|
Provider Name | Dr. Gracie-Ann Dinkins |
First Address | Lynwood, CA 90262-3513 |
Second Address | Lynwood, CA 90262-3513 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2006 |
Last Update Date | 08/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H98774 | (02) | CA |