Provider Demographics
NPI:1366598591
Name:SIEGFRIED, TRACY ANN (MD)
Entity type:Individual
Prefix:MS
First Name:TRACY
Middle Name:ANN
Last Name:SIEGFRIED
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:24331 EL TORO RD
Mailing Address - Street 2:SUITE 360
Mailing Address - City:LAGUNA WOODS
Mailing Address - State:CA
Mailing Address - Zip Code:92637-2752
Mailing Address - Country:US
Mailing Address - Phone:949-600-7733
Mailing Address - Fax:949-465-8159
Practice Address - Street 1:24221 CALLE DE LA LOUISA
Practice Address - Street 2:SUITE 400
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-7638
Practice Address - Country:US
Practice Address - Phone:949-465-8155
Practice Address - Fax:949-465-8159
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA62919207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine