Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | G45977 | CA |
N | 111NI0900X | Internist | G45977 | CA |
Y | 207RH0002X | Hospice and Palliative Medicine | G45977 | CA |
NPI | 1306862701 |
---|---|
Provider Name | Dr. Lucille Ridgill |
First Address | Rancho Palos Verdes, CA 90275-6515 |
Second Address | Rancho Palos Verdes, CA 90275-6515 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2006 |
Last Update Date | 18/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A50252 | (02) | CA |