Individual
SILKE HEINISCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, PHD
Contact information
Practice address
2950 RESEARCH PARK DR, SOQUEL, CA 95073-2000
(831) 458-5548
Mailing address
PO BOX 276950, SACRAMENTO, CA 95827-6950
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A130962
CA
207NP0225X
Pediatric Dermatology Physician
1053220
CA
390200000X
Student in an Organized Health Care Education/Training Program
MT197487
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A130962
STATE MEDICAL LICENSE
CA
Enumeration date
06/09/2010
Last updated
12/03/2024
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