Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | G077666 | CA |
NPI | 1003056821 |
---|---|
Provider Name | Allyson Jean Pizzo-Berkey |
First Address | Newport Beach, CA 92663-3509 |
Second Address | Newport Beach, CA 92663-3509 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2009 |
Last Update Date | 10/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1841749041 | (02) | CA |
F69835 | UPIN (01) | CA |