Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | A81422 | CA |
N | 207N00000X | Dermatologist | A81422 | CA |
NPI | 1619916913 |
---|---|
Provider Name | Jeanett Segal |
First Address | Lancaster, CA 93534-5504 |
Second Address | Fresno, CA 93710-3947 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 27/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H10327 | (02) | CA |
WA81422A | PPIN (01) | CA |