Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | A116418 | CA |
NPI | 1003117649 |
---|---|
Provider Name | Dr. Marit Kay Kreidel |
First Address | Irvine, CA 92604-4694 |
Second Address | Irvine, CA 92604-4694 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/11/2010 |
Last Update Date | 22/12/2021 |