Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | A-71915 | CA |
N | 207YS0123X | Facial Plastic Surgeon | A-71915 | CA |
NPI | 1962552810 |
---|---|
Provider Name | Dr. Marie Chantal Sonia Trinque Courchesne |
First Address | Pacific Palisades, CA 90272-3859 |
Second Address | Pacific Palisades, CA 90272-3859 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2007 |
Last Update Date | 11/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H47684 | (02) | CA |