Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | G079157 | CA |
NPI | 1053322784 |
---|---|
Provider Name | Dr. Kathleen Marie Murphy |
First Address | Fresno, CA 93710-5269 |
Second Address | Fresno, CA 93710-5269 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2006 |
Last Update Date | 29/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G89331 | (02) | CA |
ZZZ71868Z | (05) | CA |