Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 170100000X | Medical Geneticist | A43912 | CA |
Y | 208D00000X | General Practice Physician | A43912 | CA |
NPI | 1225140429 |
---|---|
Provider Name | Dr. Nilsa Patritti Laborde |
First Address | Torrance, CA 90503-6004 |
Second Address | Torrance, CA 90503-6004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 11/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F11035 | (02) | CA |