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NPI Code Detail

MEDICARE: HEIDI ANN HIRSBRUNNER ATC

MEDICARE:   HEIDI ANN HIRSBRUNNER  ATC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12255A2300XAthletic Trainer

General Provider Information

NPI Number : 1386607687
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEIDI ANN HIRSBRUNNER ATC
Provider Business Mailing Address
First Line : 1600 E 3RD AVE
Second Line : #2013
City : SAN MATEO
State : CA
Zip : 94401-2166
Country : US
Telephone Number : 702-493-1097
Fax Number :
Provider Business Practice Location Address
First Line : 1701 DIVISADERO ST
Second Line : SUITE 240
City : SAN FRANCISCO
State : CA
Zip : 94115-3011
Country : US
Telephone Number : 415-353-7782
Fax Number : 415-353-7593
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2006
Last Update Date : 07/08/2007

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Directions to “ HEIDI ANN HIRSBRUNNER ATC” Practice Location

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