Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0216X | Pediatric Rheumatologist | A90828 | CA |
NPI | 1720317753 |
---|---|
Provider Name | Dr. Ornella J Rullo |
First Address | Los Angeles, CA 90095-1752 |
Second Address | Los Angeles, CA 90095-1752 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2009 |
Last Update Date | 06/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A908280 | (05) | CA |