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1376881227
VITALIY VIKTOR KOSTYUKEVICH
SACRAMENTO, CA
NPI
1376881227
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: CA PA22576)
Enumeration Date
2013-01-28
Last Update Date
2022-01-03
Business Address
-- VITALIY VIKTOR KOSTYUKEVICH PA-C
4112 E COMMERCE WAY
SACRAMENTO, CA 95834-9680
Phone number: 916-396-2929
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Mailing Address
-- VITALIY VIKTOR KOSTYUKEVICH PA-C
4112 E COMMERCE WAY
SACRAMENTO, CA 95834-9680
Phone number:
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