Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 566445 | CA |
NPI | 1003247321 |
---|---|
Provider Name | Joyce Eseigbe |
First Address | Fullerton, CA 92835 |
Second Address | Fullerton, CA 92835-1835 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2013 |
Last Update Date | 12/12/2013 |