Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | A62220 | CA |
NPI | 1154343663 |
---|---|
Provider Name | Heike D Farin |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Los Angeles, CA 90095-3075 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 11/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A622200 | (05) | CA |
G97879 | (02) | CA |