Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | A77404 | CA |
NPI | 1285705244 |
---|---|
Provider Name | Naveena R. Bobba |
First Address | Fresno, CA 93711-6930 |
Second Address | Fresno, CA 93711-6930 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 10/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A774040 | (05) | CA |
I48723 | (02) |