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Individual
KRISTINE SUE PERCY
Active
Individual
KRISTINE SUE PERCY
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
G77388
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1306971262
GROUP NPI
CA
05
—
GR0101050
—
CA
01
—
ZZZ092862
BLUE SHIELD
—
Enumeration date
10/03/2006
Last updated
11/16/2012
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