Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0200X | Radiology | 27620 | CA |
Y | 213ER0200X | Radiology | 27620 | CA |
NPI | 1013185982 |
---|---|
Provider Name | Dr. Jamie K Kowal Baietto |
First Address | Placentia, CA 92870-5710 |
Second Address | Placentia, CA 92870-5710 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2008 |
Last Update Date | 13/02/2008 |