Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 18062 | CA |
NPI | 1003068289 |
---|---|
Provider Name | Margaret Carrizosa |
First Address | Palm Desert, CA 92211-6105 |
Second Address | Palm Desert, CA 92211-6105 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2008 |
Last Update Date | 10/10/2013 |