Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | A68207 | CA |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | A068207 | CA |
N | 207VG0400X | Gynecologist | A068207 | CA |
NPI | 1588652143 |
---|---|
Provider Name | Heidi Wittenberg |
First Address | San Francisco, CA 94133 |
Second Address | San Francisco, CA 94133 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/10/2005 |
Last Update Date | 16/07/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E98802 | (02) |