MEDICARE: ANNE F HENZEL

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
1	207W00000X	Ophthalmology Physician	G82266	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942355953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNE F HENZEL

Provider Business Mailing Address
First Line	:	4370 ALPINE RD
Second Line	:	SUITE 200
City	:	PORTOLA VALLEY
State	:	CA
Zip	:	94028-7952
Country	:	US
Telephone Number	:	650-325-3937
Fax Number	:	650-850-4199

Provider Business Practice Location Address
First Line	:	4370 ALPINE RD
Second Line	:	SUITE 200
City	:	PORTOLA VALLEY
State	:	CA
Zip	:	94028-7952
Country	:	US
Telephone Number	:	650-325-3937
Fax Number	:	650-850-4199

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2007
Last Update Date	:	12/01/2016

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Directions to “ ANNE F HENZEL ” Practice Location

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