Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | G83814 | CA |
NPI | 1215948740 |
---|---|
Provider Name | Dr. Leah M Pike |
First Address | Long Beach, CA 90803-7222 |
Second Address | Los Alamitos, CA 90720-3102 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2006 |
Last Update Date | 30/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1154551026 | (05) | CA |
256066600 | (05) | FL |
H02780 | (02) |