Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | A65621 | CA |
NPI | 1326058991 |
---|---|
Provider Name | Michelle Dawn Adams |
First Address | Los Altos, CA 94022-1408 |
Second Address | Oakland, CA 94609-1710 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 25/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A656210 | (05) | CA |
A65621 | STATE MEDICAL LICENSE (01) | CA |
G25918 | (02) |