Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | G33157 | CA |
NPI | 1023053816 |
---|---|
Provider Name | Dr. Donna Heicher Conom |
First Address | Monte Sereno, CA 95030-2136 |
Second Address | Monte Sereno, CA 95030-2136 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2006 |
Last Update Date | 08/07/2007 |