Provider Demographics
NPI:1003441148
Name:MINEO, HEATHER K (DVM, DACVECC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:K
Last Name:MINEO
Suffix:
Gender:F
Credentials:DVM, DACVECC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1908 SPAHN LN
Mailing Address - Street 2:
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-2844
Mailing Address - Country:US
Mailing Address - Phone:714-496-3693
Mailing Address - Fax:
Practice Address - Street 1:1908 SPAHN LN
Practice Address - Street 2:
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-2844
Practice Address - Country:US
Practice Address - Phone:714-496-3693
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-10
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14536207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Multi-Specialty