Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207W00000X | Ophthalmologist | 240221 | NY |
Y | 207W00000X | Ophthalmologist | A87565 | CA |
NPI | 1023040714 |
---|---|
Provider Name | Dr. Miguel Angel Unzueta |
First Address | Los Angeles, CA 90033-2424 |
Second Address | Los Angeles, CA 90033-2424 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 01/03/2012 |