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1164528469
JOSE MARIO D CUYEGKENG FONTANILLA
SANTA ROSA, CA
NPI
1164528469
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207RI0200X Internal Medicine Infectious Disease
(Licence: WV 23108)
Enumeration Date
2006-09-15
Last Update Date
2021-12-15
Business Address
DR. JOSE MARIO D CUYEGKENG FONTANILLA M.D.
401 BICENTENNIAL WAY
SANTA ROSA, CA 95403-2149
Phone number: 707-393-4704
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Mailing Address
DR. JOSE MARIO D CUYEGKENG FONTANILLA M.D.
401 BICENTENNIAL WAY
SANTA ROSA, CA 95403-2149
Phone number: 707-393-4704
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