Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | C35798 | CA |
NPI | 1528168580 |
---|---|
Provider Name | Sharon Kay Muenchow |
First Address | Pasadena, CA 91105-3418 |
Second Address | Glendora, CA 91741-4240 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2006 |
Last Update Date | 17/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A87823 | (02) |