Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | A145176 | CA |
NPI | 1154705259 |
---|---|
Provider Name | Ismael Corral JR. |
First Address | Torrance, CA 90509 |
Second Address | Torrance, CA 90509 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2015 |
Last Update Date | 16/09/2021 |