Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | G23566 | CA |
NPI | 1043301344 |
---|---|
Provider Name | Lynda Karen Fisher |
First Address | Los Angeles, CA 90027-6062 |
Second Address | Los Angeles, CA 90027-6062 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 17/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G235660 | (05) | CA |
A41997 | (02) | CA |