Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | A96243 | CA |
NPI | 1033228739 |
---|---|
Provider Name | Dr. Dorotheea Oana Warmerdam |
First Address | Sacramento, CA 95816 |
Second Address | Roseville, CA 95661-2942 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 05/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
GR0042242 | (05) | CA |