Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | A163273 | CA |
Y | 2080A0000X | Adolescent Medicine | A163273 | CA |
NPI | 1184981797 |
---|---|
Provider Name | Dr. Kanani Elaine Titchen |
First Address | San Diego, CA 92123-4223 |
Second Address | San Diego, CA 92123-2758 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2012 |
Last Update Date | 06/05/2020 |