Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | G80690 | CA |
NPI | 1336116854 |
---|---|
Provider Name | Dr. Jacqueline Lezine-Hanna |
First Address | Marina Del Rey, CA 90292-6313 |
Second Address | Marina Del Rey, CA 90292-6313 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H52202 | (02) | CA |