Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | G55663 | CA |
NPI | 1952415226 |
---|---|
Provider Name | Ms. Ann Arcay |
First Address | Dana Point, CA 92629-2852 |
Second Address | Santa Ana, CA 92701-4519 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
WG55663A | PPIN (01) | CA |