Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | G36794 | CA |
NPI | 1205075843 |
---|---|
Provider Name | Dr. Jane R Udkoff |
First Address | Westlake Village, CA 91362-5228 |
Second Address | Westlake Village, CA 91362-5228 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2009 |
Last Update Date | 04/02/2009 |