MEDICARE: DR. ANNA-KAISA NIEMI M.D., PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207SG0201X	Clinical Genetics (M.D.) Physician	A104907	CA
2	207SG0202X	Clinical Biochemical Genetics Physician	A104907	CA
3	208000000X	Pediatrics Physician	A104907	CA
4	2080N0001X	Neonatal-Perinatal Medicine Physician	A104907	CA

General Provider Information

NPI Number	:	1497941397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNA-KAISA NIEMI M.D., PH.D.

Provider Business Mailing Address
First Line	:	3020 CHILDRENS WAY # MC5003
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-4223
Country	:	US
Telephone Number	:	858-309-6300
Fax Number	:	858-966-7483

Provider Business Practice Location Address
First Line	:	3020 CHILDRENS WAY
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123
Country	:	US
Telephone Number	:	858-309-6300
Fax Number	:	858-966-7483

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/25/2007
Last Update Date	:	07/11/2018

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