Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | A70842 | CA |
NPI | 1013005636 |
---|---|
Provider Name | Elainie D Doringo |
First Address | San Diego, CA 92123-4802 |
Second Address | El Cajon, CA 92020-6035 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2006 |
Last Update Date | 30/01/2015 |