Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0200X | Radiology | DC12717 | CA |
Y | 213ER0200X | Radiology | DC12717 | CA |
NPI | 1487721973 |
---|---|
Provider Name | Dr. Sharon Ann Jaeger |
First Address | Valley Village, CA 91607-2736 |
Second Address | Valley Village, CA 91607-2736 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2006 |
Last Update Date | 08/07/2007 |