Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 20091 | CA |
N | 207R00000X | Internist | 20091 | CA |
N | 111NI0900X | Internist | 20091 | CA |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 20091 | CA |
NPI | 1578982435 |
---|---|
Provider Name | Mrs. Sheilah Maureen Kraetzel |
First Address | Glendale, CA 91206-4163 |
Second Address | Glendale, CA 91206-4007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2014 |
Last Update Date | 08/04/2014 |