Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | C29028 | CA |
NPI | 1083721344 |
---|---|
Provider Name | Dr. Roger M Katz |
First Address | Los Angeles, CA 90064-1524 |
Second Address | Los Angeles, CA 90064-1538 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2006 |
Last Update Date | 05/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00C290281 | (05) | CA |
A33814 | (02) | CA |