Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | 49903 | CA |
Y | 204E00000X | Oral & Maxillofacial Surgeon | 49903 | CA |
NPI | 1407931694 |
---|---|
Provider Name | Miss Nora Kahenasa |
First Address | Los Angeles, CA 90049-4214 |
Second Address | Los Angeles, CA 90095-4907 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2006 |
Last Update Date | 26/03/2013 |