Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | A135588 | CA |
NPI | 1043535776 |
---|---|
Provider Name | Dr. Katie Lynn Osley |
First Address | Long Beach, CA 90807-3492 |
Second Address | Long Beach, CA 90807-3492 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2010 |
Last Update Date | 24/11/2020 |