Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | A45141 | CA |
NPI | 1013029909 |
---|---|
Provider Name | Dr. Henedina Liban |
First Address | El Monte, CA 91731-2629 |
Second Address | El Monte, CA 91731-2629 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A45141 | (02) | CA |