Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 200700073 | NC |
NPI | 1013034412 |
---|---|
Provider Name | Michelle Taylor Corbier |
First Address | Santa Maria, CA 93458-7310 |
Second Address | Santa Maria, CA 93455-2118 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2007 |
Last Update Date | 22/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5911145 | (05) | NC |