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1760979637
LAURENCE NIKKO CRISOSTOMO
ELK GROVE, CA
NPI
1760979637
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: CA NP95005664)
Enumeration Date
2018-04-17
Last Update Date
2018-04-17
Business Address
LAURENCE NIKKO CRISOSTOMO NP
6617 TRONZANO WAY
ELK GROVE, CA 95757-3057
Phone number: 916-627-6663
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Mailing Address
LAURENCE NIKKO CRISOSTOMO NP
89 LINCOLN BLVD STE 100
LINCOLN, CA 95648-8096
Phone number: 916-543-1593
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