Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | G44618 | CA |
NPI | 1043256316 |
---|---|
Provider Name | Dr. Robert W Eitches |
First Address | Los Angeles, CA 90048-5901 |
Second Address | Los Angeles, CA 90048-5901 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2006 |
Last Update Date | 14/11/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A92503 | (02) | CA |