Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | A130894 | CA |
NPI | 1033491311 |
---|---|
Provider Name | Dr. Leidy J Tovar Padua |
First Address | San Diego, CA 92123-4223 |
Second Address | San Diego, CA 92123-4232 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2011 |
Last Update Date | 16/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2080P0208X | CHLAMG (01) | CA |