Healthcare Provider Details

I. General information

NPI: 1588742050
Provider Name (Legal Business Name): MINDY PLOTKIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 LA CASA VIA STE 200
WALNUT CREEK CA
94598-3011
US

IV. Provider business mailing address

112 LA CASA VIA STE 200
WALNUT CREEK CA
94598-3011
US

V. Phone/Fax

Practice location:
  • Phone: 925-933-4747
  • Fax: 925-935-3559
Mailing address:
  • Phone: 925-933-4747
  • Fax: 925-935-3559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number20A7310
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: