Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | G52635 | CA |
NPI | 1023097383 |
---|---|
Provider Name | Peggy Albrecht |
First Address | Santa Cruz, CA 95062-1323 |
Second Address | Soquel, CA 95073-2000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/01/2006 |
Last Update Date | 07/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F22350 | (02) |