Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0105X | Surgery of the Hand | A112103 | CA |
Y | 2086S0122X | Plastic and Reconstructive Surgery | A112103 | CA |
NPI | 1780822171 |
---|---|
Provider Name | Dr. Katherine Janice Fu |
First Address | Rancho Mirage, CA 92270-1774 |
Second Address | Rancho Mirage, CA 92270 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2009 |
Last Update Date | 24/09/2019 |