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1477132835
IAN TIMOTHY FITZGERALD
MODESTO, CA
NPI
1477132835
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: CA 59623)
Additional Taxonomies
363A00000X Physician Assistant
Enumeration Date
2021-04-05
Last Update Date
2024-04-02
Business Address
IAN TIMOTHY FITZGERALD PA-C
1700 COFFEE RD
MODESTO, CA 95355-2803
Phone number: 209-601-4054
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Mailing Address
IAN TIMOTHY FITZGERALD PA-C
1700 COFFEE RD
MODESTO, CA 95355-2803
Phone number:
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