Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 01058183A | IN |
N | 207QA0401X | Family Doctor - Addiction Medicine | 01058183A | IN |
N | 207QA0505X | Family Doctor - Adult Medicine | 01058183A | IN |
NPI | 1558454207 |
---|---|
Provider Name | Sophie Szewczyk Aalaei |
First Address | San Diego, CA 92101-3597 |
Second Address | San Diego, CA 92101-3597 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 29/10/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200911300 | (05) | IN |