Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | A147343 | CA |
N | 2080P0208X | Pediatric Infectious Diseases | MT210528 | PA |
NPI | 1114269248 |
---|---|
Provider Name | Erlinda Ulloa |
First Address | Philadelphia, PA 19104-4319 |
Second Address | San Diego, CA 92123-4223 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2013 |
Last Update Date | 17/03/2018 |