Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0201X | Pediatric Allergist | A91589 | CA |
NPI | 1427193457 |
---|---|
Provider Name | Lyne Goodlett Scott |
First Address | Van Nuys, CA 91405-2434 |
Second Address | Los Angeles, CA 90033-1365 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2007 |
Last Update Date | 08/07/2007 |