Provider Demographics
NPI:1598802613
Name:PICKERSGILL, ANNE JUDITH (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:JUDITH
Last Name:PICKERSGILL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2500 HOSPITAL DR # 11
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-4106
Mailing Address - Country:US
Mailing Address - Phone:650-962-8055
Mailing Address - Fax:650-969-0170
Practice Address - Street 1:2500 HOSPITAL DR
Practice Address - Street 2:#11
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-4106
Practice Address - Country:US
Practice Address - Phone:650-962-8055
Practice Address - Fax:650-969-0170
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2009-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA30607207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A306071Medicaid
CA00A306071Medicaid
CA00A306070Medicare PIN