Derdzinska, Anna B

Derdzinska, Anna B is an individual health care provider with primary practice located at 2720 Low Ct , Fairfield CA 94534-9771. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Derdzinska, Anna B can be contacted via phone (707) 427-4900.

Contact Information

Primary practice address
2720 Low Ct Fairfield CA 94534-9771
Fax: (707) 434-2090
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X A42489 California

Profile Details

NPI number 1578650883
LBN Legal business name Derdzinska, Anna B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 6th, 2006
Last updated May 8th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578650883 NPPES
California MEDICAID 00A424890

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