Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | G70574 | CA |
N | 111NI0900X | Internist | G70574 | CA |
N | 207RI0200X | Infectious Disease | G70574 | CA |
NPI | 1033134572 |
---|---|
Provider Name | Dr. Susan J Little |
First Address | San Diego, CA 92103-2005 |
Second Address | San Diego, CA 92103-2005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G705740 | (05) | CA |
F49113 | (02) | CA |