Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | A95332 | CA |
Y | 2080P0216X | Pediatric Rheumatologist | A95332 | CA |
NPI | 1154463024 |
---|---|
Provider Name | Dr. Michal Jennifer Cidon |
First Address | Los Angeles, CA 90010-2814 |
Second Address | Los Angeles, CA 90027-6062 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2007 |
Last Update Date | 19/07/2017 |