Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | C144047 | CA |
NPI | 1073722021 |
---|---|
Provider Name | Paula Michelle Mesarwi |
First Address | San Diego, CA 92193-2410 |
Second Address | La Jolla, CA 92093-3875 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 30/08/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
048729500 | (05) | MD |
BP1-0022667 | INSTITUTIONAL PERMIT (01) |