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General NPI Number Information
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NPI Number | 1144247107
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Entity Type | Individual
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Provider Name | ANNA LIVIZ D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 03/01/2009
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Provider Practice Location Address
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Address Line | 324 N SAN MATEO DR STE 2
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City | SAN MATEO
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State | CA
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Zip | 94401-2514
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Country | US
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Telephone | 650-343-5555
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Fax | 650-343-2225
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Provider Business Mailing Address
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Address Line | 1161 BLYTHE ST
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City | FOSTER CITY
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State | CA
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Zip | 94404-3645
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Country | US
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Telephone | 650-574-3366
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Fax | 650-343-2225
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 42175
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License Number State | CA
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