Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | A94189 | CA |
Y | 2080P0208X | Pediatric Infectious Diseases | A94189 | CA |
NPI | 1053636993 |
---|---|
Provider Name | Mikhaela Cielo |
First Address | Los Angeles, CA 90033-1029 |
Second Address | Los Angeles, CA 90033-1029 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2010 |
Last Update Date | 13/06/2012 |