Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | G36354 | CA |
N | 208000000X | Pediatrician | G36354 | CA |
NPI | 1407996093 |
---|---|
Provider Name | Dr. Marcia Ehinger |
First Address | Carmichael, CA 95608-0950 |
Second Address | Sacramento, CA 95814-4051 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2007 |
Last Update Date | 12/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G363540 | (05) | CA |
C04210 | (02) |