Provider Demographics
NPI:1124249396
Name:POINSETT, PIERRETTE MIMI (MD)
Entity type:Individual
Prefix:
First Name:PIERRETTE
Middle Name:MIMI
Last Name:POINSETT
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 1:11875 DUBLIN BLVD
Mailing Address - Street 2:SUITE B125
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568
Mailing Address - Country:US
Mailing Address - Phone:925-587-2505
Mailing Address - Fax:925-587-2511
Practice Address - Street 1:3100 TELEGRAPH AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609
Practice Address - Country:US
Practice Address - Phone:510-452-5231
Practice Address - Fax:510-899-8392
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA46569208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics