Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 51521 | CA |
Y | 213EG0000X | General Practice | 51521 | CA |
NPI | 1003841438 |
---|---|
Provider Name | Dr. Jane Skuben-Vadkerti |
First Address | Fullerton, CA 92831-5527 |
Second Address | Fullerton, CA 92831-5527 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 23/07/2021 |