Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | G23946 | CA |
NPI | 1013072610 |
---|---|
Provider Name | Dr. Judith Claire Schiffner |
First Address | Menlo Park, CA 94025-6227 |
Second Address | San Mateo, CA 94403-4364 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/12/2006 |
Last Update Date | 14/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G239461 | INDIVIDUAL PTAN (01) | CA |
ZZZ25753Z | GROUP PTAN (01) | CA |