Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | G10927 | CA |
NPI | 1124128145 |
---|---|
Provider Name | Louis M Zucker |
First Address | Santa Monica, CA 90402-3126 |
Second Address | Los Angeles, CA 90015-1329 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2006 |
Last Update Date | 17/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A38123 | (02) |