Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0204X | Pediatric Emergency Doctor | 35084138 | OH |
Y | 2080P0204X | Pediatric Emergency Doctor | A100330 | CA |
NPI | 1265469704 |
---|---|
Provider Name | Leah S Tzimenatos |
First Address | Sacramento, CA 95817 |
Second Address | Sacramento, CA 95817 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 24/07/2007 |