Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | A174812 | CA |
NPI | 1548757644 |
---|---|
Provider Name | Lynne Holsclaw |
First Address | Duarte, CA 91010-3012 |
Second Address | Duarte, CA 91010-3012 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2018 |
Last Update Date | 09/11/2021 |