Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | A132946 | CA |
Y | 2080P0214X | Pediatric Pulmonologist | A132946 | CA |
NPI | 1255674479 |
---|---|
Provider Name | Ruth Siew |
First Address | San Diego, CA 92123-4223 |
Second Address | San Diego, CA 92123 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2013 |
Last Update Date | 25/06/2019 |