Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 8879 | CA |
NPI | 1013080845 |
---|---|
Provider Name | Natalie A. Mc Cain |
First Address | Long Beach, CA 90806 |
Second Address | San Diego, CA 92103-6308 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
MR1379076 | DEA (01) | CA |