Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | A69765 | CA |
NPI | 1407998164 |
---|---|
Provider Name | Dr. Alexandra Lee Haessler |
First Address | Los Altos, CA 94022-1408 |
Second Address | San Francisco, CA 94109 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2007 |
Last Update Date | 26/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A69765 | STATE MEDICAL LICENSE (01) | CA |