Provider Demographics
NPI:1194816678
Name:PFLUM, JEANNIE LEE (DO)
Entity Type:Individual
Prefix:
First Name:JEANNIE
Middle Name:LEE
Last Name:PFLUM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 PIONEER LN
Mailing Address - Street 2:
Mailing Address - City:BISHOP
Mailing Address - State:CA
Mailing Address - Zip Code:93514-2556
Mailing Address - Country:US
Mailing Address - Phone:707-526-5034
Mailing Address - Fax:707-545-3984
Practice Address - Street 1:350 POSADA LANE
Practice Address - Street 2:SUITE 202
Practice Address - City:TEMPLETON
Practice Address - State:CA
Practice Address - Zip Code:93465-4060
Practice Address - Country:US
Practice Address - Phone:805-434-5497
Practice Address - Fax:805-434-0917
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A7910207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX79100Medicaid
CA00AX79100Medicaid
H43745Medicare UPIN