Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | A73952 | CA |
NPI | 1922104223 |
---|---|
Provider Name | Dr. Katherine Wesseling Perry |
First Address | Los Angeles, CA 90095 |
Second Address | Los Angeles, CA 90095 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2006 |
Last Update Date | 22/09/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A739520 | (05) | CA |