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General NPI Number Information
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NPI Number | 1417068867
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Entity Type | Organization
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Legal Business Name | HEIFETZ & PALMER, MD'S, A MEDICAL CORPORATION
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10956 DONNER PASS RD SUITE 210
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City | TRUCKEE
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State | CA
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Zip | 96161-4861
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Country | US
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Telephone | 530-582-6450
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Fax | 530-550-8169
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Provider Business Mailing Address
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Address Line | PO BOX 26525 SECTION #3051
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City | OKLAHOMA CITY
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State | OK
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Zip | 73126-0525
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Country | US
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Telephone | 918-806-1024
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Fax | 918-286-7381
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | LAURENCE J HEIFETZ
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Credential | MD
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Telephone | 530-582-6450
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number |
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License Number State |
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