Alice Park MD

NPI 1891795076 - Psychiatry & Neurology - 2084P0800X

NPI Details
NPI 1891795076
Gender Female
Enumeration Date 07/28/2005
Last Updated 07/08/2007
Entity Type Individual
Active Over 11 years ago
Practice Location
1305 TOMMYDON ST
STOCKTON CA, 95210-3364, US
Phone (209) 476-5200
Fax
Business Location
3749 WHISPERING CREEK CIR
STOCKTON CA, 95219-2329, US
Phone (209) 952-5156
Fax
Toxanomy
Taxonomy Code 2084P0800X
License State Texas
License Number L8157
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According to our database, Alice Park MD NPI is 1891795076, taxonomy code is 2084P0800X and license number is L8157, license state is located at Texas. Alice Park MD physically located at 1305 Tommydon St, Stockton CA, 95210-3364. NPI Number Alice Park MD has the Individual type.

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1891795076 NPI number is provided on an as is basis without warranty of any kind. 1891795076 is maintained by the National Plan & Provider Enumeration System. The contents of Alice Park MD are for informational purposes only.