Provider Information for 1205587169
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HEIDI ANNE LAHL
Sex: Female
NPI: 1205587169
Last Updated: 2024-05-01
Certification Date: 2024-05-01
Certification Date: 2024-05-01
Details
Name | Value | ||||||||||||||
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NPI | 1205587169 | ||||||||||||||
Enumeration Date | 2022-01-12 | ||||||||||||||
NPI Type | NPI-1 Individual | ||||||||||||||
Sole Proprietor | YES | ||||||||||||||
Status | Active | ||||||||||||||
Mailing Address | PO BOX 156814 SAN FRANCISCO, CA 94115-6814 United States Phone: 707-685-6943 | Fax: | ||||||||||||||
Primary Practice Address | PO BOX 156814 SAN FRANCISCO, CA 94115-6814 United States Phone: 707-685-6943 | Fax: | ||||||||||||||
Secondary Practice Address(es) | 224 KAMEHAMEHA AVE | ||||||||||||||
Health Information Exchange |
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