Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0214X | Pediatric Pulmonologist | 29579 | AZ |
Y | 2080P0214X | Pediatric Pulmonologist | A104961 | CA |
NPI | 1376745018 |
---|---|
Provider Name | Dr. Kimberly Nalani Otsuka |
First Address | Loma Linda, CA 92350-1700 |
Second Address | Loma Linda, CA 92354-3450 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2007 |
Last Update Date | 24/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H49172 | (02) | AZ |