Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | G39048 | CA |
NPI | 1013088913 |
---|---|
Provider Name | Pamela S. Wald |
First Address | Baldwin Park, CA 91706-5806 |
Second Address | Baldwin Park, CA 91706-5806 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 23/09/2008 |