Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | A149799 | CA |
Y | 2080N0001X | Neonatal-Perinatal Doctor | A149799 | CA |
NPI | 1043617897 |
---|---|
Provider Name | Dr. Sheila Kalyanam |
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 | 21/11/2014 |
Last Update Date | 01/11/2021 |