Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | A479151 | CA |
Y | 2080P0208X | Pediatric Infectious Diseases | A149151 | CA |
NPI | 1154308062 |
---|---|
Provider Name | Dr. Mose Arditi |
First Address | Los Angeles, CA 90051-0717 |
Second Address | Los Angeles, CA 90048-1865 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/12/2005 |
Last Update Date | 29/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E75994 | (02) | CA |