Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 170100000X | Medical Geneticist | G53909 | PA |
Y | 2086S0122X | Plastic and Reconstructive Surgery | G53909 | CA |
NPI | 1629076856 |
---|---|
Provider Name | Dr. Susan Kaweski |
First Address | La Mesa, CA 91941 |
Second Address | La Mesa, CA 91941-5303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2005 |
Last Update Date | 04/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1145416243 | (05) | CA |
1629076856 | (05) | CA |
G37658 | (02) | |
W17191 | (02) | CA |