Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | E2997 | CA |
NPI | 1083724330 |
---|---|
Provider Name | Katherine R. Noeller |
First Address | Murrieta, CA 92562-5978 |
Second Address | Murrieta, CA 92562-5978 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 15/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000E29970 | (05) | CA |
U98038 | (02) |