| NPI Details | |
|---|---|
| NPI | 1164572186 |
| Gender | Male |
| Enumeration Date | 01/11/2007 |
| Last Updated | 07/29/2015 |
| Entity Type | Individual |
| Active | Over 11 years ago |
| Practice Location | |
|---|---|
| 2068 JOHN JONES ROAD SUITE # 3116 DAVIS CA, 95616-9711, US |
|
| Phone | (530) 747-0389 |
| Fax | (530) 747-0623 |
| Business Location | |
|---|---|
| 10470 OLD PLACERVILLE RD SUITE 100 SACRAMENTO CA, 95827-2539, US |
|
| Phone | (800) 470-0071 |
| Fax | (530) 747-0623 |
| Toxanomy | |
|---|---|
| Taxonomy Code | 207RG0100X |
| License State | California |
| License Number | A97807 |
| Remove 1164572186 NPI Number | |
According to our database, Ian J Logan M.D. NPI is 1164572186, taxonomy code is 207RG0100X and license number is A97807, license state is located at California. Ian J Logan M.D. physically located at 2068 John Jones Road, Davis CA, 95616-9711. NPI Number Ian J Logan M.D. has the Individual type.
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1164572186 NPI number is provided on an as is basis without warranty of any kind. 1164572186 is maintained by the National Plan & Provider Enumeration System. The contents of Ian J Logan M.D. are for informational purposes only.
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