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1629603667
AVINESH PRAKASH
SACRAMENTO, CA
NPI
1629603667
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: CA 95014139)
Enumeration Date
2020-03-10
Last Update Date
2021-07-29
Business Address
Mr. AVINESH PRAKASH
2315 STOCKTON BLVD
SACRAMENTO, CA 95817-2201
Phone number: 916-734-8556
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Mailing Address
Mr. AVINESH PRAKASH
1441 FLORIDA AVE
MODESTO, CA 95350-4404
Phone number: 209-576-3525
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