Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RG0100X | Gastroenterologist | 123309 | OH |
Y | 207RG0100X | Gastroenterologist | A162022 | CA |
NPI | 1003182593 |
---|---|
Provider Name | Mr. Feng Li |
First Address | Los Angeles, CA 90017-4810 |
Second Address | Los Angeles, CA 90017-4881 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2012 |
Last Update Date | 29/11/2021 |