Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | A51258 | CA |
N | 207RC0000X | Internist - Cardiovascular Disease | A51258 | CA |
NPI | 1548295116 |
---|---|
Provider Name | Liset Stoletniy |
First Address | Los Angeles, CA 90074-4701 |
Second Address | Loma Linda, CA 92354-2804 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 02/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A512580 | (05) | CA |
G82142 | (02) |