Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | G48550 | CA |
NPI | 1053356089 |
---|---|
Provider Name | Sheila M Braunstein |
First Address | Sacramento, CA 95825-6206 |
Second Address | Sacramento, CA 95825-6206 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2006 |
Last Update Date | 08/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B57885 | (02) | CA |
GR0048630 | (05) | CA |