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General NPI Number Information
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NPI Number | 1245272947
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Entity Type | Individual
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Provider Name | DONNA LOUISE SEGARRA D.O.
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Gender | Female
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Dates
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Enumeration Date | 06/10/2006
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Last Update Date | 04/06/2015
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Provider Practice Location Address
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Address Line | 7317 CENTRAL AVE NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87108-2015
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Country | US
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Telephone | 505-200-3320
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Fax | 877-860-2279
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Provider Business Mailing Address
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Address Line | 200 OCEANGATE SUITE 100
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City | LONG BEACH
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State | CA
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Zip | 90802-4317
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Country | US
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Telephone | 562-499-6191
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Fax | 562-499-6171
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MB02875300
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A4585
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20827
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A567-71
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License Number State | NM
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