Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | G87546 | CA |
Y | 111NI0900X | Internist | G87546 | CA |
N | 207RH0002X | Hospice and Palliative Medicine | G87546 | CA |
NPI | 1306030192 |
---|---|
Provider Name | Nancy O'malley |
First Address | Arroyo Grande, CA 93420-3359 |
Second Address | Arroyo Grande, CA 93420-3359 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2007 |
Last Update Date | 12/10/2016 |