Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | G64317 | CA |
NPI | 1013936194 |
---|---|
Provider Name | Jeanette Kaye Oka |
First Address | Pasadena, CA 91101-3005 |
Second Address | Torrance, CA 90505-5002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G43170 | (05) | CA |
00G43170 | BLUE SHIELD (01) | CA |
F22992 | (02) |