Basic Information
| Provider Information | |||||||||
| NPI: | 1295901072 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REETZ | ||||||||
| FirstName: | HEIDI | ||||||||
| MiddleName: | JOHANNA | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 500 PARNASSUS AVE FL 4 | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941432203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4154769035 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 500 PARNASSUS AVE FL 4 | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941432203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4154769035 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2008 | ||||||||
| LastUpdateDate: | 04/17/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | M-11600 | ID | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | A11101 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.