Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 19336 | CA |
NPI | 1013247063 |
---|---|
Provider Name | Olga Slavinskaya |
First Address | Los Angeles, CA 90048 |
Second Address | Los Angeles, CA 90048 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/01/2010 |
Last Update Date | 13/01/2010 |