Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | G41338 | CA |
NPI | 1629169107 |
---|---|
Provider Name | Sally Louise Davidson Ward |
First Address | Los Angeles, CA 90010-2804 |
Second Address | Los Angeles, CA 90027-6062 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2006 |
Last Update Date | 08/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G413380 | (05) | CA |
00G413380 G81 | CAL OPTIMA (01) | CA |
E96945 | (02) | CA |