Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | 95009559 | CA |
NPI | 1053898924 |
---|---|
Provider Name | Tamar Lori Knadjian-Hindin |
First Address | Woodland Hills, CA 91367-4516 |
Second Address | Santa Monica, CA 90404-2054 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2018 |
Last Update Date | 24/07/2018 |