Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | G51463 | CA |
Y | 208600000X | Surgeon | G51463 | CA |
N | 2086S0129X | Vascular Surgeon | G51463 | CA |
NPI | 1134214455 |
---|---|
Provider Name | Loie Goldfield Sauer |
First Address | Graton, CA 95444 |
Second Address | Sebastopol, CA 95472-9738 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 03/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G514630 | (05) | CA |
E25332 | (02) |