TIMOTHY WAYNE MANSOURI

FOLSOM, CA
NPI1770970899
Other NameTIM MANSOURI
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy163WP0000X Registered Nurse, Pain Management
(Licence: CA  95003073)
Additional Taxonomies163WP0000X Registered Nurse, Pain Management
(Licence: CA  656576)
Enumeration Date2015-04-16
Last Update Date2020-03-03
Business Address
TIMOTHY WAYNE MANSOURI Nurse Practitioner
1600 CREEKSIDE DR STE 2400
FOLSOM, CA 95630-3485
Phone number: 916-932-4163
Mailing Address
TIMOTHY WAYNE MANSOURI Nurse Practitioner
8732 FLUTE CIR
ELK GROVE, CA 95757-1742
Phone number: 209-765-8297