Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 22199 | CA |
NPI | 1043562275 |
---|---|
Provider Name | Mrs. Alexandra Elise Saborio |
First Address | Los Angeles, CA 90065-2522 |
Second Address | West Hollywood, CA 90048-1804 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2012 |
Last Update Date | 22/10/2012 |