# DR. HEIDI C MIST

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1154461416
- **Gender:** F
- **Credential:** MD, MPH&TM

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | A80054 | CA | Yes |

## Other

- **Enumeration date:** 02/07/2007
- **Last updated:** 08/24/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 53909G | — | CA |
| 05 | — | GR0089251 | — | CA |