Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 54416 | CA |
NPI | 1093733925 |
---|---|
Provider Name | Dr. Ilse Savelli |
First Address | Chula Vista, CA 91911-1209 |
Second Address | Chula Vista, CA 91911-1209 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 19/09/2013 |