Individual
ARIADNE GUINEVERE LIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5800 HOLLIS ST, EMERYVILLE, CA 94608-2016
(510) 806-2238
Mailing address
5800 HOLLIS ST, EMERYVILLE, CA 94608-2016
(510) 806-2238
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
252084
NY
207R00000X
Internal Medicine Physician
Primary
C175923
CA
208000000X
Pediatrics Physician
252084
NY
208000000X
Pediatrics Physician
C175923
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05168438
—
NY
Enumeration date
08/15/2006
Last updated
04/19/2024
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