Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | A158036 | CA |
NPI | 1417186438 |
---|---|
Provider Name | Nancy Luo |
First Address | Sacramento, CA 95865-5228 |
Second Address | Sacramento, CA 95816-5616 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2009 |
Last Update Date | 25/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A158036 | MEDICAL STATE LICENSE (01) | CA |