Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | G69152 | CA |
NPI | 1194943324 |
---|---|
Provider Name | Joanne Eunjoo Paek |
First Address | Davis, CA 95616-6525 |
Second Address | Vacaville, CA 95688-9430 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2007 |
Last Update Date | 08/07/2007 |