Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | G33254 | CA |
N | 2080N0001X | Neonatal-Perinatal Doctor | G33254 | CA |
NPI | 1083777569 |
---|---|
Provider Name | Gregory Paul Heldt |
First Address | San Diego, CA 92123-4800 |
Second Address | San Diego, CA 92103-9001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G332540 | (05) | CA |