Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VE0102X | Reproductive Endocrinologist | A63220 | CA |
Y | 207VX0000X | Obstetrician | A63220 | CA |
N | 207VX0201X | Gynecologic Oncologist | A63220 | CA |
NPI | 1306873294 |
---|---|
Provider Name | Oliver Dorigo |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Los Angeles, CA 90095-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 15/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A632200 | (05) | CA |
H50344 | (02) | CA |