Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | A52640 | CA |
Y | 207Q00000X | Family Doctor | A052640 | CA |
N | 207QA0401X | Family Doctor - Addiction Medicine | A052640 | CA |
NPI | 1073657367 |
---|---|
Provider Name | Juliet La Mers |
First Address | San Francisco, CA 94145-0680 |
Second Address | Placerville, CA 95667-5721 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2007 |
Last Update Date | 22/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A526400 | (05) | CA |