Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0402X | Child Neurologist | BP10024120 | TX |
Y | 2084N0402X | Child Neurologist | C171744 | CA |
NPI | 1033309836 |
---|---|
Provider Name | Dr. Sailaja Golla |
First Address | Orange, CA 92868-4203 |
Second Address | Orange, CA 92868-4203 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2007 |
Last Update Date | 10/08/2021 |