Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | A132394 | CA |
N | 207SG0201X | Clinical Genetics (M.D.) | MD15651 | HI |
N | 208000000X | Pediatrician | 57.010596 | OH |
N | 208000000X | Pediatrician | A132394 | CA |
NPI | 1023224557 |
---|---|
Provider Name | Dr. Thomas Slavin JR. |
First Address | La Crescenta, CA 91214-3103 |
Second Address | La Crescenta, CA 91214-3103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2007 |
Last Update Date | 03/03/2020 |