Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 101973 | CA |
Y | 1223X0400X | Orthodontists | 101973 | CA |
NPI | 1033764592 |
---|---|
Provider Name | Lauren Hanna Frisch |
First Address | Pasadena, CA 91101-2279 |
Second Address | Burbank, CA 91505-2118 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2019 |
Last Update Date | 07/02/2022 |