Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | A94984 | CA |
NPI | 1306033741 |
---|---|
Provider Name | Kathleen Marie Brennan |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Los Angeles, CA 90095-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2007 |
Last Update Date | 12/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A949840 | (05) | CA |