Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | A84185 | CA |
NPI | 1003830258 |
---|---|
Provider Name | Dr. Sandra Nieto |
First Address | Whittier, CA 90605-1246 |
Second Address | Whittier, CA 90605-2152 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 03/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003830258 | (05) | CA |
1003830258 | NPI (01) | CA |
AR026A | MEDICARE PTAN (01) | CA |
I45474 | (02) | CA |