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Physician Last Name: | Mabatid | |||
Physician First Name: | Heidi | |||
Physician Middle Name: | ||||
Address: | 12984 Lake Wildwood Drive Penn Valley, California 95946 | |||
License Number: | 144665 | |||
License Type: | MD | |||
Year of Birth: | ||||
Effective Date: | 12/06/1996 | |||
Action Description for DOH Webpage: | License revocation | |||
Misconduct Description for DOH Webpage: | The Hearing Committee sustained the charge finding the physician had been convicted after a General Court Martial held by the U.S. Air Force of negligent dereliction of duty; signing a false document allowing her divorced husband to continue to use his military dependent's card to receive medical treatment, and larceny. | |||
License Limitations or Conditions for DOH Webpage: | ||||
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