Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | G67534 | CA |
NPI | 1457387250 |
---|---|
Provider Name | Sharon Marie Dreeben |
First Address | San Diego, CA 92121-2119 |
Second Address | San Diego, CA 92121-2119 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 02/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G675340 | (05) | CA |
E64314 | (02) | CA |