Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | A104812 | CA |
N | 208000000X | Pediatrician | A104812 | CA |
NPI | 1255538450 |
---|---|
Provider Name | Dr. Julia Nicole Magana |
First Address | Sacramento, CA 95817-1460 |
Second Address | Sacramento, CA 95817 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2007 |
Last Update Date | 16/08/2018 |