Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | A28619 | CA |
NPI | 1023119708 |
---|---|
Provider Name | Victor Passy |
First Address | Los Angeles, CA 90030-0220 |
Second Address | Downey, CA 90242-3456 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 22/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A25447 | (02) | CA |