Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | G76862 | CA |
NPI | 1013935238 |
---|---|
Provider Name | Katherine Elizabeth White |
First Address | Los Angeles, CA 90074-2939 |
Second Address | Los Angeles, CA 90095-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G768620 | MEDICAL PPIN # (01) | CA |
F78464 | (02) | CA |