Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VG0400X | Gynecologist | G72001 | CA |
Y | 207VX0201X | Gynecologic Oncologist | G72001 | CA |
NPI | 1386649713 |
---|---|
Provider Name | Lynda D Roman |
First Address | Los Angeles, CA 90033-1038 |
Second Address | Pasadena, CA 91105-3154 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2005 |
Last Update Date | 26/11/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G720010 | (05) | CA |
B98160 | (02) | CA |