Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MT209629 | PA |
N | 208600000X | Surgeon | MT209629 | PA |
Y | 2086S0122X | Plastic and Reconstructive Surgery | A165032 | CA |
NPI | 1073994455 |
---|---|
Provider Name | Andrea Zaw |
First Address | Sacramento, CA 95817 |
Second Address | Sacramento, CA 95817 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2015 |
Last Update Date | 16/07/2021 |