Provider Demographics
NPI:1730115601
Name:GIESEMANN, CORINNE (MD)
Entity Type:Individual
Prefix:
First Name:CORINNE
Middle Name:
Last Name:GIESEMANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:26671 ALISO CREEK RD.
Mailing Address - Street 2:STE 206B
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656
Mailing Address - Country:US
Mailing Address - Phone:949-791-3199
Mailing Address - Fax:949-791-3181
Practice Address - Street 1:120 CRAVEN RD
Practice Address - Street 2:STE 101
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-4236
Practice Address - Country:US
Practice Address - Phone:760-591-0955
Practice Address - Fax:760-591-3680
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2021-11-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA67809207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH20745Medicare UPIN