Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 45022 | CA |
NPI | 1003823899 |
---|---|
Provider Name | Dr. Hemamalini Srinivasan |
First Address | San Diego, CA 92117-2708 |
Second Address | San Diego, CA 92117-2708 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2006 |
Last Update Date | 08/07/2007 |