Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 001069 | NY |
Y | 208000000X | Pediatrician | C129786 | CA |
N | 2080P0204X | Pediatric Emergency Doctor | 001069 | NY |
NPI | 1316972250 |
---|---|
Provider Name | Dr. Rosalie Fernandez Sia |
First Address | Atwater, CA 95301-5167 |
Second Address | Modesto, CA 95350-4437 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 17/03/2018 |