Healthcare Provider Details
I. General information
NPI: 1306993530
Provider Name (Legal Business Name): LOUISE MCNITT MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/03/2007
Last Update Date: 05/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2500 ALHAMBRA AVE
MARTINEZ CA
94553-3156
US
IV. Provider business mailing address
597 CENTER AVE SUITE 200A
MARTINEZ CA
94553-4640
US
V. Phone/Fax
- Phone: 925-313-6740
- Fax: 925-313-6465
- Phone: 925-313-6740
- Fax: 925-313-6465
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2083P0901X |
| Taxonomy | Public Health & General Preventive Medicine Physician |
| License Number | A92020 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: