Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | A063453 | CA |
NPI | 1629057096 |
---|---|
Provider Name | Gina Lokna |
First Address | Sacramento, CA 95816-4307 |
Second Address | Sacramento, CA 95816-4307 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2006 |
Last Update Date | 02/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G91163 | (02) |