Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | A25565 | CA |
NPI | 1043452782 |
---|---|
Provider Name | Loula Amin |
First Address | Newport Beach, CA 92660-5599 |
Second Address | Newport Beach, CA 92660-5599 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2009 |
Last Update Date | 26/03/2009 |