Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RR0500X | Rheumatology | A168383 | CA |
Y | 2080P0216X | Pediatric Rheumatologist | A168383 | CA |
NPI | 1386878700 |
---|---|
Provider Name | Nicole Galgoul Bitencourt |
First Address | Loma Linda, CA 92354 |
Second Address | Loma Linda, CA 92354 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2009 |
Last Update Date | 11/12/2020 |