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Individual
KELLY PFEIFER
Active
Individual
KELLY PFEIFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A66577
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A66577
LICENSE
CA
05
—
BCP70696F
—
CA
05
—
FHC70696F
—
CA
05
—
HAP70696F
—
CA
01
—
ZZZ18742Z
ISSUER MEDICARE
CA
Enumeration date
08/18/2005
Last updated
12/17/2007
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