Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | ND1012 | CA |
NPI | 1093280265 |
---|---|
Provider Name | Dr. Mary Pardee |
First Address | Los Angeles, CA 90066-5198 |
Second Address | Los Angeles, CA 90067-2001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2018 |
Last Update Date | 03/10/2018 |