Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | G68785 | CA |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | G68785 | CA |
NPI | 1033192356 |
---|---|
Provider Name | Dr. Kimberly Gregory |
First Address | Los Angeles, CA 90051-0717 |
Second Address | Los Angeles, CA 90048-1865 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2005 |
Last Update Date | 17/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D99825 | (02) | CA |