Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | G10704 | CA |
NPI | 1023042496 |
---|---|
Provider Name | Mr. Dudley S Danoff |
First Address | Los Angeles, CA 90048-6101 |
Second Address | Los Angeles, CA 90048-6101 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 07/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A38049 | (02) | CA |