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1174790224
WALLACE BLAKE MCKINNEY
SACRAMENTO, CA
NPI
1174790224
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207P00000X Emergency Medicine
(Licence: CA A105593)
Enumeration Date
2008-05-08
Last Update Date
2008-09-24
Business Address
-- WALLACE BLAKE MCKINNEY M.D.
4150 V ST PSSB 2100
SACRAMENTO, CA 95817-1460
Phone number: 916-734-8571
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Mailing Address
-- WALLACE BLAKE MCKINNEY M.D.
4150 V ST PSSB 2100
SACRAMENTO, CA 95817-1460
Phone number: 916-734-8571
Copy
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