Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 252027 | NY |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 126246 | OR |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | A122587 | CA |
NPI | 1124285572 |
---|---|
Provider Name | Dr. Alyssa C. Luddy |
First Address | Oakland, CA 94611-5641 |
Second Address | Oakland, CA 94611-5641 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2008 |
Last Update Date | 11/02/2022 |