Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | G85295 | CA |
NPI | 1609949627 |
---|---|
Provider Name | Louanne Hudgins |
First Address | Palo Alto, CA 94305-5208 |
Second Address | Palo Alto, CA 94305-5208 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2006 |
Last Update Date | 03/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
BH1704813 | DEA (01) | CA |
E69659 | (02) | CA |
G85295 | MEDICAL LICENSE (01) | CA |