Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | A130937 | CA |
NPI | 1104105535 |
---|---|
Provider Name | Ms. Manal Habib |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Los Angeles, CA 90095-8344 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2011 |
Last Update Date | 26/05/2021 |