Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | DC15421 | CA |
NPI | 1962758250 |
---|---|
Provider Name | Eileen Marie Cremata |
First Address | Alamo, CA 94507-1747 |
Second Address | Alamo, CA 94507-1747 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2012 |
Last Update Date | 24/07/2012 |