Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A105713 | CA |
N | 111NI0900X | Internist | A105713 | CA |
Y | 2080P0210X | Pediatric Nephrologist | A105713 | CA |
NPI | 1780835058 |
---|---|
Provider Name | Elaine Ku |
First Address | Alhambra, CA 91801-6911 |
Second Address | Los Angeles, CA 90033-1029 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2008 |
Last Update Date | 08/12/2017 |