Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 46888 | CA |
Y | 213EG0000X | General Practice | 46888 | CA |
NPI | 1003253576 |
---|---|
Provider Name | Dr. Margarita Metrikina |
First Address | Los Angeles, CA 90046-3421 |
Second Address | Los Angeles, CA 90046-3421 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2013 |
Last Update Date | 24/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G93322 | DENTI-CAL (01) | CA |