Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC21913 | CA |
NPI | 1013001635 |
---|---|
Provider Name | Mrs. Monika Ann Buerger |
First Address | Livermore, CA 94551 |
Second Address | Livermore, CA 94551 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DC0219130 | BLUE SHIELD ID NUMBER (01) | CA |
U33470 | (02) | CA |