DE TAN

SACRAMENTO, CA
NPI1851384044
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207RG0100X Internal Medicine, Gastroenterology
(Licence: CA  A90989)
Enumeration Date2005-08-24
Last Update Date2018-12-20
Business Address
DE TAN
2725 CAPITOL AVE DEPT 300
SACRAMENTO, CA 95816-6006
Phone number: 916-262-9370
Mailing Address
DE TAN
10470 OLD PLACERVILLE RD STE 100
SACRAMENTO, CA 95827-2539
Phone number: 800-470-0071
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