is a Medical in Citrus Heights, California. practices all healthcare services and medical treatments related to Medical. The NPI Number for is 1770740789. The last update date is .
's current location address is 8001 Madison Ave, Citrus Heights, California. You can contact this provider via phone number 9165362420 and fax number 9169857844. The mailing address for is 8001 Madison Ave, Citrus Heights, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 8001 Madison Ave, Citrus Heights, California |
| Phone Number | 9165362420 |
| Fax Number | 9169857844 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1770740789 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 8001 Madison Ave |
|---|---|
| City | Citrus Heights |
| State | California (CA) |
| Post Code | 956107901 |
| Phone Number | 9165362420 |
| Fax Number | 9169857844 |
Provider's Primary Taxonomy Detail
| Speciality | Medical |
|---|---|
| Taxonomy | 363Am0700X |
| Licence No | PA 19570 |
|
Definition: A licensed healthcare professional who practices medicine under physician supervision focusing on medical diagnoses and treatment. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| GR0078350 | CA | MEDICAL |
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