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Individual
DR. HEIDI C MIST
Active
Individual
DR. HEIDI C MIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD, MPH&TM
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
A80054
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
53909G
—
CA
05
—
GR0089251
—
CA
Enumeration date
02/07/2007
Last updated
08/24/2012
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