Basic Information
| Provider Information | |||||||||
| NPI: | 1972655090 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NYE | ||||||||
| FirstName: | ANN | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | MILIGAN | ||||||||
| OtherFirstName: | ANN | ||||||||
| OtherMiddleName: | MARIE | ||||||||
| OtherNamePrefix: | MISS | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 577 AIRPORT BLVD | ||||||||
| Address2: | STE 300 | ||||||||
| City: | BURLINGAME | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940102020 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6502408198 | ||||||||
| FaxNumber: | 4083285695 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 S SAN MATEO DR | ||||||||
| Address2: | |||||||||
| City: | SAN MATEO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 944013805 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6506964427 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/17/2007 | ||||||||
| LastUpdateDate: | 02/18/2015 | ||||||||
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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 | G82080 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.