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Individual
MEREDITH L HEIDENFELD
Active
Individual
MEREDITH L HEIDENFELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
54355
CA
363A00000X
Physician Assistant
PA2004-0013
NM
363AM0700X
Medical Physician Assistant
PA2004-0013
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19809352
—
NM
Enumeration date
07/07/2005
Last updated
07/21/2022
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