Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | A110435 | CA |
NPI | 1265783872 |
---|---|
Provider Name | Maria Elizabeth Nelson |
First Address | Los Angeles, CA 90031-0309 |
Second Address | Los Angeles, CA 90033-5331 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2012 |
Last Update Date | 19/10/2020 |