Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | A71242 | CA |
N | 207VX0000X | Obstetrician | A71242 | CA |
NPI | 1164564100 |
---|---|
Provider Name | Bonnie Dwyer |
First Address | Mountain View, CA 94040-6201 |
Second Address | Mountain View, CA 94040-2833 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2007 |
Last Update Date | 02/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I12717 | (02) | CA |