Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | A118232 | CA |
NPI | 1003080896 |
---|---|
Provider Name | Dr. Kimberly Elizabeth Idoko |
First Address | Encino, CA 91436-5300 |
Second Address | Encino, CA 91436-5300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2008 |
Last Update Date | 30/06/2021 |