Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | A65355 | CA |
N | 208200000X | Surgeon | A65355 | CA |
N | 208600000X | Surgeon | A65355 | CA |
NPI | 1033201421 |
---|---|
Provider Name | Ms. Ellie Maghami |
First Address | Los Angeles, CA 90051-0185 |
Second Address | Duarte, CA 91010-3012 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2006 |
Last Update Date | 13/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A663550 | (05) | CA |
125102 | (02) |