Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | A72635 | CA |
NPI | 1003858283 |
---|---|
Provider Name | Michaela Straznicka |
First Address | Walnut Creek, CA 94598-2512 |
Second Address | Walnut Creek, CA 94598-2512 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 25/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H65712 | (02) | CA |