Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | A135891 | CA |
NPI | 1922236868 |
---|---|
Provider Name | Lucia Silu Olarte |
First Address | Los Angeles, CA 90067-2001 |
Second Address | Los Angeles, CA 90067-2001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2009 |
Last Update Date | 07/11/2019 |