Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 227519 | NY |
NPI | 1013982826 |
---|---|
Provider Name | Lara Zibners |
First Address | Carmichael, CA 95608-2840 |
Second Address | Carmichael, CA 95608-2840 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2006 |
Last Update Date | 17/02/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02459823 | (05) | NY |
H99494 | (02) |