Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 10665 | CA |
NPI | 1033174545 |
---|---|
Provider Name | Ms. Mary Pat Schoenbaum |
First Address | Los Angeles, CA 90031-0309 |
Second Address | Los Angeles, CA 90033-5310 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2006 |
Last Update Date | 25/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
S75481 | (02) |