Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | A111883 | CA |
NPI | 1003075037 |
---|---|
Provider Name | Dr. Inna Keselman |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Los Angeles, CA 90095 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2008 |
Last Update Date | 17/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003075037 | (05) | CA |