Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | G36194 | CA |
NPI | 1013941483 |
---|---|
Provider Name | Dr. Stuart Holden |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Los Angeles, CA 90095-6101 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 08/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A46605 | (02) | CA |