Healthcare Provider Details

I. General information

NPI: 1124249396
Provider Name (Legal Business Name): PIERRETTE MIMI POINSETT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 TELEGRAPH AVE 2ND FLOOR
OAKLAND CA
94609
US

IV. Provider business mailing address

11875 DUBLIN BLVD SUITE B125
DUBLIN CA
94568
US

V. Phone/Fax

Practice location:
  • Phone: 510-452-5231
  • Fax: 510-899-8392
Mailing address:
  • Phone: 925-587-2505
  • Fax: 925-587-2511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA46569
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: