Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | G074936 | CA |
NPI | 1144322462 |
---|---|
Provider Name | Nancy Tepper Weintraub |
First Address | Sepulveda, CA 91343 |
Second Address | Sepulveda, CA 91343 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B18796 | (02) |