Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | A168145 | CA |
NPI | 1043637234 |
---|---|
Provider Name | Dr. Jennifer Kolb |
First Address | Orange, CA 92868 |
Second Address | Orange, CA 92868 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2014 |
Last Update Date | 20/07/2020 |