Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | DRK24 | CA |
NPI | 1215095864 |
---|---|
Provider Name | Dr. Elizabeth Anne Trachtenberg |
First Address | Berkeley, CA 94705-2231 |
Second Address | Oakland, CA 94609-1809 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2006 |
Last Update Date | 08/07/2007 |