Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 146289 | CA |
Y | 2080P0202X | Pediatric Cardiologist | 274639 | MA |
NPI | 1215449830 |
---|---|
Provider Name | Dr. Ryan Kobayashi |
First Address | Boston, MA 02115-5724 |
Second Address | Los Angeles, CA 90027-6062 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/11/2017 |
Last Update Date | 15/12/2021 |