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1104824994
JACK WAXMAN
SANTA ROSA, CA
NPI
1104824994
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207RR0500X Internal Medicine, Rheumatology
(Licence: CA G23398)
Enumeration Date
2005-07-14
Last Update Date
2024-03-27
Business Address
JACK WAXMAN M.D.
4015 QUARTZ DR
SANTA ROSA, CA 95405-5580
Phone number: 707-481-7215
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Mailing Address
JACK WAXMAN M.D.
4015 QUARTZ DR
SANTA ROSA, CA 95405-5580
Phone number: 707-481-7215
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