Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QG0300X | Family Doctor - Geriatric Medicine | A144960 | CA |
Y | 207R00000X | Internist | A144960 | CA |
Y | 111NI0900X | Internist | A144960 | CA |
N | 207RH0002X | Hospice and Palliative Medicine | A144960 | CA |
NPI | 1316332349 |
---|---|
Provider Name | Katelyn Dow Stepanyan |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Santa Monica, CA 90404 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2015 |
Last Update Date | 15/11/2019 |