is a Adolescent Medicine in Ukiah, California. practices all healthcare services and medical treatments related to Adolescent Medicine. The NPI Number for is 1063524460. The last update date is .
's current location address is 260 Hospital Dr, Ukiah, California. You can contact this provider via phone number 7074638000 and fax number 7074621111. The mailing address for is 260 Hospital Dr, Ukiah, California. To know further, please read the information below!
Provider Profile Detail
Provider Name | |
---|---|
Address | 260 Hospital Dr, Ukiah, California |
Phone Number | 7074638000 |
Fax Number | 7074621111 |
Sole Proprietor | -- |
Credentials | -- |
NPI Number Detail
NPI Number | 1063524460 |
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Provider Enumeration Date | |
Last Updated Date |
Provider Mailing Address Detail
Address | 260 Hospital Dr |
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City | Ukiah |
State | California (CA) |
Post Code | 954824533 |
Phone Number | 7074638000 |
Fax Number | 7074621111 |
Provider's Primary Taxonomy Detail
Speciality | Adolescent Medicine |
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Taxonomy | 2080A0000X |
Licence No | MD048496L |
Definition: A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
---|---|---|---|
366976 | PA | CIGNA | |
42469 | PA | AETNA | |
575394 | PA | HIGHMARK | |
000000853A | PA | UPMC | |
90923 | PA | -- | |
0012644510003OU | PA | -- | |
14521480001 | PA | -- |
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