Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | G69498 | CA |
NPI | 1083792188 |
---|---|
Provider Name | Kara L. Riley-Paull |
First Address | Walnut Creek, CA 94597-2168 |
Second Address | Walnut Creek, CA 94596-5318 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2006 |
Last Update Date | 26/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G694980 | (05) | CA |
E21321 | (02) |