Provider Demographics
NPI:1407867203
Name:ZIEGNER, ULRIKE H (MD PHD)
Entity Type:Individual
Prefix:DR
First Name:ULRIKE
Middle Name:H
Last Name:ZIEGNER
Suffix:
Gender:F
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1970 S PROSPECT AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-6005
Mailing Address - Country:US
Mailing Address - Phone:310-792-9050
Mailing Address - Fax:310-792-9048
Practice Address - Street 1:1970 S PROSPECT AVE STE 3
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-6005
Practice Address - Country:US
Practice Address - Phone:310-792-9050
Practice Address - Fax:310-792-9048
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA55506174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG75815Medicare UPIN
CAWA55506CMedicare PIN