Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0216X | Pediatric Rheumatologist | 527692 | CA |
NPI | 1639345150 |
---|---|
Provider Name | Paola Pederzoli-Carrillo |
First Address | Los Angeles, CA 90095-7901 |
Second Address | Los Angeles, CA 90095-3075 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2008 |
Last Update Date | 21/07/2021 |