Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | A50462 | CA |
NPI | 1336187343 |
---|---|
Provider Name | Inna Lamport |
First Address | Beverly Hills, CA 90211-2382 |
Second Address | South Pasadena, CA 91030-3507 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2006 |
Last Update Date | 13/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A504621 | (05) | CA |
F51351 | (02) | CA |