Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 003649 | OH |
NPI | 1073839155 |
---|---|
Provider Name | Eunis Bello |
First Address | Pasadena, CA 91110-0698 |
Second Address | Phoenix, AZ 85016-5319 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2010 |
Last Update Date | 01/05/2015 |