Individual
ANABEL S FACEMIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
280 SIERRA COLLEGE DR STE 105, GRASS VALLEY, CA 95945
(530) 477-4480
(530) 477-3100
Mailing address
3400 DATA DR, ATTN: CREDENTIALING/PAYER ENROLLMENT, RANCHO CORDOVA, CA 95670-7956
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD60518877
WA
207RC0000X
Cardiovascular Disease Physician
Primary
C135547
CA
207RC0000X
Cardiovascular Disease Physician
MD60518877
WA
207UN0901X
Nuclear Cardiology Physician
MD60518877
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2041554
—
WA
Enumeration date
09/16/2005
Last updated
06/05/2018
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