Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | A111581 | CA |
N | 2080P0203X | Pediatric Critical Care Doctor | A111581 | CA |
NPI | 1265696975 |
---|---|
Provider Name | Humam Alosh |
First Address | Woodlake, CA 93286-1301 |
Second Address | Woodlake, CA 93286-1301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2008 |
Last Update Date | 17/09/2018 |