Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | G71395 | CA |
NPI | 1629153598 |
---|---|
Provider Name | Mrs. Laurie Ellen Schweitzer |
First Address | Berkeley, CA 94705-2152 |
Second Address | Berkeley, CA 94705 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2006 |
Last Update Date | 22/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G713951 | (05) | CA |
F39557 | (02) | CA |